Presentation (CTI)

OBJECTIVES: To estimate the cost-effectiveness of lecanemab plus standard of care (SoC) versus SoC alone in patients with early AD, i.e., mild cognitive impairment (MCI) due to AD or mild AD dementia, with confirmed beta-amyloid pathology, from the healthcare system perspective and a broader societal perspective in Switzerland.
METHODS: A Markov model was developed to estimate AD progression and cost-effectiveness over the lifetime of patients with early AD who received either lecanemab plus SoC or SoC alone. Lecanemab efficacy was modelled based on data from the Phase III study of lecanemab in early AD, Clarity AD. Unit costs and mortality rates by age were taken from publicly available sources, while natural history data, institutionalisation rates, mortality risk ratios and utility values for each health state were taken from the published literature. A lifetime time horizon was adopted.
RESULTS: Treatment with lecanemab was associated with an increase in quality-adjusted life years over the model time horizon as well as incurring incremental costs for both the MCI due to AD and mild AD dementia populations, with the incremental cost-effectiveness ratio (ICER) below 1x GDP per capita. Including a societal perspective reduced the ICER for lecanemab plus SoC versus SoC further.
CONCLUSIONS: Lecanemab represents a potentially cost-effective option for the treatment of early AD from the Swiss healthcare system and societal perspective. Delaying AD progression with lecanemab potentially improves health outcomes of AD patients and their caregivers. This cost effectiveness analysis captures the health economic value of a new treatment for which a traditional Swiss assessment based on internal reference pricing may not be suitable.