Budget Impact of Lecanemab for Alzheimer's Disease Patients Among Medicare Beneficiaries in the United States: A Subgroup Analysis

OBJECTIVES: Nearly 6.7 million Americans 65 and older will have Alzheimer's by 2023. Thus, 73% of the population is 75 years of age or older. The projected frequency of AD worldwide in 2050 is 12.7 million. Acetylcholinesterase inhibitors (AChEIs) including donepezil, galantamine, and rivastigmine, are used to treat mild and severe AD. Alzheimer's and other dementias will cost the US $345 billion in 2023, of which $222 billion will come from Medicare and Medicaid. This study aims to determine the effect of Lecanemab on total healthcare costs for treating AD across stages, gender, and race in the US.

METHODS: A budget impact model, accounting for gender, racial, and health state differences, was created to calculate the financial effect of using Lecanemab to treat AD. A cohort of 1 million was chosen and modeled over 3 years in both with and without Lecanemab scenarios. Inputs included market share, costs, length of therapy, and patient compliance projections. The difference in annual costs and PMPM/per treated member was used to determine the budget impact with deterministic sensitivity analyses to examine how changes in parameters affected the model results.

RESULTS: The estimated budget impact of introducing Lecanemab for treating eligible patients with Alzheimer's disease in the US from a health plan of one million members over three years is $300,788,773.6, with an incremental PMPM cost of $8.4 and a PTMPM cost of $92.5. We controlled the effects of health states, gender, and race. We found differences across health stages, whereas the only differences across gender and race pertained to the overall budget impact. Sensitivity analysis suggests a modest increase in budget, mainly due to improved compliance and acquisition costs.

CONCLUSIONS: Lecanemab, a treatment option for adults with AD, had a minimal impact on US health plan budgets with the potential for improved patient adherence through six annual doses.