CROSS-VALIDATION OF AN EARLY COST-EFFECTIVENESS MODEL FOR SPECTRIS™ THERAPY USING THE ALZHEIMER’S DISEASE OPEN-SOURCE IPECAD MODEL FRAMEWORK
Author(s)
Chantal W. van Gils, MSc, PhD, MD1, Joseph D. Massey, MEng2, Kai-Erh Kao, MSc3, Karissa M. Johnston, BSc, MSc, PhD3, Kathleen A. Troeger, MPH4;
1SSI Strategy, VP Evidence and Value, Rotterdam, Netherlands, 2SSI Strategy, London, United Kingdom, 3Broadstreet HEOR, Vancouver, BC, Canada, 4Cognito Therapeutics, Cambridge, MA, USA
1SSI Strategy, VP Evidence and Value, Rotterdam, Netherlands, 2SSI Strategy, London, United Kingdom, 3Broadstreet HEOR, Vancouver, BC, Canada, 4Cognito Therapeutics, Cambridge, MA, USA
OBJECTIVES: An estimated 7.2 million Americans live with Alzheimer’s disease (AD), generating $384 billion in annual healthcare costs. The International Pharmaco-Economic Collaboration on Alzheimer’s Disease (IPECAD) model provides a transparent reference framework for evaluating economic models in Alzheimer’s disease. Cognito Therapeutics previously developed an economic model to assess Spectris™, a clinical-stage, noninvasive, at-home therapy designed to slow disease progression and preserve brain structure. This study evaluates the performance of our prior model within the 2025 IPECAD framework and examines structural and parameter-driven differences.
METHODS: The prior five-state Markov model (MCI, mild, moderate, severe AD, death) was mapped to IPECAD v2.3. Population characteristics, natural history, utilities, and medical costs were aligned. Effectiveness assumptions (RR 0.3-0.7; 0.3 from OVERTURE I) were implemented within IPECAD constraints allowing benefit only in MCI and mild AD and discontinuing treatment at moderate AD. Acquisition cost inputs ranged from $10,000-$60,000.
RESULTS: IPECAD produced more conservative estimates. Compared to the prior model, the IPECAD-Spectris replication yielded lower overall costs (3-9%) and QALYs (11-15%), lower incremental costs (9-57%) and QALYs (29-45%) versus standard-of-care treatment. These differences largely aligned with the QALY gains and cost-savings observed when IPECAD replicated ICER’s lecanemab model. Differences arose from variations in model structure, including inability to capture treatment effects in moderate disease, and from differing parameter inputs, such as simplified cost assumptions. Using a $100,000/QALY threshold, Spectris demonstrated potential cost-effectiveness with total acquisition costs between $17,831 (RR = 0.7) and $61,383 (RR = 0.3), with the IPECAD model.
CONCLUSIONS: Cross-validation with IPECAD shows that, utilizing inputs from the OVERTURE pilot study, Spectris potentially represents a highly cost-effective AD treatment within a conservative structurally restrictive framework that undervalue therapies designed for mild and moderate AD. Ensuring future reference models are fit-for-purpose across all disease stages and therapy types will be essential for accurate HTA assessments and equitable reimbursement decisions.
METHODS: The prior five-state Markov model (MCI, mild, moderate, severe AD, death) was mapped to IPECAD v2.3. Population characteristics, natural history, utilities, and medical costs were aligned. Effectiveness assumptions (RR 0.3-0.7; 0.3 from OVERTURE I) were implemented within IPECAD constraints allowing benefit only in MCI and mild AD and discontinuing treatment at moderate AD. Acquisition cost inputs ranged from $10,000-$60,000.
RESULTS: IPECAD produced more conservative estimates. Compared to the prior model, the IPECAD-Spectris replication yielded lower overall costs (3-9%) and QALYs (11-15%), lower incremental costs (9-57%) and QALYs (29-45%) versus standard-of-care treatment. These differences largely aligned with the QALY gains and cost-savings observed when IPECAD replicated ICER’s lecanemab model. Differences arose from variations in model structure, including inability to capture treatment effects in moderate disease, and from differing parameter inputs, such as simplified cost assumptions. Using a $100,000/QALY threshold, Spectris demonstrated potential cost-effectiveness with total acquisition costs between $17,831 (RR = 0.7) and $61,383 (RR = 0.3), with the IPECAD model.
CONCLUSIONS: Cross-validation with IPECAD shows that, utilizing inputs from the OVERTURE pilot study, Spectris potentially represents a highly cost-effective AD treatment within a conservative structurally restrictive framework that undervalue therapies designed for mild and moderate AD. Ensuring future reference models are fit-for-purpose across all disease stages and therapy types will be essential for accurate HTA assessments and equitable reimbursement decisions.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE349
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Neurological Disorders