A Causal Inference Study: The Impact of the Combined Administration of Donepezil and Memantine on Decreasing Hospital and Emergency Department Visits of Alzheimer’s Disease Patients

Authors

Ehsan Yaghmaei, Chapman UniversityFollow
Albert Pierce, Chapman UniversityFollow
Hongxia Lu, University of North Carolina at Chapel Hill
Yesha M. Patel, Chapman University
Louis Ehwerhemuepha, Children’s Hospital of Orange County
Ahmad Rezaie, Chapman University
Seyed Ahmad Sajjadi, University of California, Irvine
Cyril Rakovski, Chapman UniversityFollow

Document Type

Article

Publication Date

9-14-2023

Abstract

Alzheimer’s disease is the most common type of dementia that currently affects over 6.5 million people in the U.S. Currently there is no cure and the existing drug therapies attempt to delay the mental decline and improve cognitive abilities. Two of the most commonly prescribed such drugs are Donepezil and Memantine. We formally tested and confirmed the presence of a beneficial drug-drug interaction of Donepezil and Memantine using a causal inference analysis. We applied doubly robust estimators to one of the largest and high-quality medical databases to estimate the effect of two commonly prescribed Alzheimer’s disease (AD) medications, Donepezil and Memantine, on the average number of hospital or emergency department visits per year among patients diagnosed with AD. Our results show that, compared to the absence of medication scenario, the Memantine monotherapy, and the Donepezil monotherapy, the combined use of Donepezil and Memantine treatment significantly reduces the average number of hospital or emergency department visits per year by 0.078 (13.8%), 0.144 (25.5%), and 0.132 days (23.4%), respectively. The assessed decline in the average number of hospital or emergency department visits per year is consequently associated with a substantial reduction in medical costs. As of 2022, according to the Alzheimer’s Disease Association, there were over 6.5 million individuals aged 65 and older living with AD in the US alone. If patients who are currently on no drug treatment or using either Donepezil or Memantine alone were switched to the combined used of Donepezil and Memantine therapy, the average number of hospital or emergency department visits could decrease by over 613 thousand visits per year. This, in turn, would lead to a remarkable reduction in medical expenses associated with hospitalization of AD patients in the US, totaling over 940 million dollars per year.

Comments

This article was originally published in PLoS ONE, volume 18, issue 9, in 2023. https://doi.org/10.1371/journal.pone.0291362

Recommended Citation

Yaghmaei E, Pierce A, Lu H, Patel YM, Ehwerhemuepha L, Rezaie A, et al. (2023) A causal inference study: The impact of the combined administration of Donepezil and Memantine on decreasing hospital and emergency department visits of Alzheimer’s disease patients. PLoS ONE 18(9): e0291362. https://doi.org/10.1371/journal.pone.0291362

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1

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This work is licensed under a Creative Commons Attribution 4.0 License.