Presentation (CTI)

OBJECTIVES: To estimate the impact of lecanemab (LEC) treatment on health outcomes of Japanese patients with early Alzheimer’s disease (ie, mild cognitive impairment [MCI] or mild dementia due to AD) using a cost-effectiveness model.
METHODS: A Markov model was developed to estimate disease progression over the lifetime of patients with early AD who received either LEC with standard of care (SOC) or SOC alone. LEC efficacy for 0-18 months was assessed by transitions between the health states, and beyond 18 months, the hazard ratio for time-to-worsening of Clinical Dementia Rating-Sum of Boxes (CDR-SB) estimated from Clarity AD was used. The model assumes a constant rate of treatment discontinuation, and all patients discontinue LEC after reaching moderate AD, or upon entering nursing home.
RESULTS: In the simulation of Japanese patients with MCI due to AD (mean age 71.46 years, 68% female), LEC extended the mean time spent in early AD by 1.63 years (LEC+SOC vs. SOC: 6.92 vs. 5.29) and reduced the time in severe AD, which is associated with high mortality risk, by 0.96 years (2.81 vs. 3.77). The overall mean survival time was extended by 0.90 years with LEC (11.29 vs. 10.39). Moreover, LEC extended the mean time spent living at home (vs. nursing home) by 1.04 years (10.15 vs. 9.11). In the simulation of patients with mild AD, the mean time spent in early AD was extended by 1.09 years (4.38 vs. 3.29), while the time in severe AD was reduced by 0.84 years (3.83 vs 4.68). With LEC the estimated mean survival time was increased by 0.62 years (10.04 vs. 9.42). The mean LEC treatment duration was 4.18 years, when initiated at MCI due to AD stage, and 2.41 years, when initiated at mild AD stage.
CONCLUSIONS: LEC delayed disease progression in Japanese patients with early AD, preserving their independence longer.