Presentation (CTI)

OBJECTIVES: Alzheimer’s disease (AD) is a degenerative brain disease characterized by progressive loss of cognitive ability. It is the most common cause of dementia in the United States (US) and is the sixth leading cause of death. Direct medical costs of health care related to AD are estimated to be around $345 billion in 2023 and are projected to increase substantially over the coming decade. This research aims to evaluate trontinemab, a new investigational anti-amyloid treatment and determine an economically justifiable price.
METHODS: An early economic Markov model was developed to compare trontinemab in addition to supportive care to supportive care alone over a lifetime horizon. Results are presented from a modified societal perspective. The model tracks disease severity through community care and long-term care settings and models quality-adjusted life years (QALYs), and total costs incurred for each treatment arm. Scenario analyses evaluated alternative price points to identify the maximum price at which the incremental cost-effectiveness ratio (ICER) remained below commonly cited willingness-to-pay (WTP) thresholds of $50,000, $100,000, and $150,000 per QALY.
RESULTS: At a baseline potential annual list price of $26,500, the addition of trontinemab results in $221,217 of additional costs with an incremental QALY gain of 1.39 compared to supportive care alone over the lifetime of a patient, for an ICER of $159,148 per QALY. Using the default model parameters, economically justifiable prices were estimated to be $14,350 and $24,608 at WTP thresholds of $100,000 and $150,000 per QALY, respectively. A best-case scenario produced price points of $21,961 and $36,078 at $100,000 and $150,000 per QALY, respectively.
CONCLUSIONS: Patients treated with Trontinemab received increases in QALYs, however at considerable cost increases. Ultimately, despite increased reported efficacy compared to existing anti-amyloid options, trontinemab’s cost effectiveness is subject to substantial uncertainty as results are based on a select report from very early clinical testing.