UPDATED COST-EFFECTIVENESS OF LECANEMAB IN EARLY ALZHEIMER'S DISEASE: A CANADIAN SOCIETAL PERSPECTIVE
Author(s)
Oliver Burn, MSc1, David Trueman, MSc1, Kate Molloy, MSc2, Adam Haynes, BSc, MSc3, Ashley Concessio, MSc4, Erin OY Wong, PhD5, Kevin Xue, BSc, PhD5, Sumeet Singh, BSc, MSc6, Simon Rothwell, PhD7, Carolyn Bodnar, BSc, MA8.
1Source Health Economics, Holmrook, United Kingdom, 2Source Health Economics, London, United Kingdom, 3Eisai Limited, Grimsby, ON, Canada, 4Eisai Limited, Toronto, ON, Canada, 5EVERSANA, Toronto, ON, Canada, 6EVERSANA, Nepean, ON, Canada, 7Eisai Ltd, Hatfield, United Kingdom, 8Eisai Limited, Hatfield, United Kingdom.
1Source Health Economics, Holmrook, United Kingdom, 2Source Health Economics, London, United Kingdom, 3Eisai Limited, Grimsby, ON, Canada, 4Eisai Limited, Toronto, ON, Canada, 5EVERSANA, Toronto, ON, Canada, 6EVERSANA, Nepean, ON, Canada, 7Eisai Ltd, Hatfield, United Kingdom, 8Eisai Limited, Hatfield, United Kingdom.
OBJECTIVES: To evaluate the cost-effectiveness from a Canadian societal perspective of lecanemab versus standard of care (SoC) for the treatment of adult patients with a clinical diagnosis of mild cognitive impairment or mild dementia due to Alzheimer’s disease (AD) (early Alzheimer’s disease) who are apolipoprotein E ε4 (ApoE ε4) noncarriers or heterozygotes and who have confirmed amyloid pathology.
METHODS: An updated Markov cohort model was developed with health states defined by Clinical Dementia Rating-Sum of Boxes (CDR-SB). Disease progression during the trial period (0-18 months) was informed by Clarity AD, with longer-term progression estimated using external longitudinal data. The model incorporates treatment discontinuation upon progression to moderate AD or institutionalization and captures caregiver quality of life and productivity impacts. Key updates versus the previously presented model at AAN 2025 include: (1) 2026 Canadian cost inputs, (2) caregiver utility estimation using an incremental approach, (3) inclusion of treatment waning scenarios, (4) incorporation of a friction cost approach option for caregiver productivity losses, and (5) incorporation of extended open-label extension data (38- and 48-months). A lifetime horizon and societal perspective were adopted, with costs and outcomes discounted at 1.5% annually.
RESULTS: In the prior base case for the indicated population, lecanemab was associated with gains of 0.86 life-years and 1.70 QALYs, with incremental costs of approximately CAD 80,096, resulting in an ICUR of CAD 47,153 per QALY. The updated ICUR, probabilistic results, and scenario analyses will be presented, reflecting a more decision-relevant assessment aligned with the most recent data and evolving HTA expectations.
CONCLUSIONS: An updated cost-effectiveness model incorporating recent evidence and HTA-driven methodological refinements is needed to accurately assess the value of lecanemab in Canada. These changes strengthen the relevance of economic evidence for healthcare decision-making in early AD.
METHODS: An updated Markov cohort model was developed with health states defined by Clinical Dementia Rating-Sum of Boxes (CDR-SB). Disease progression during the trial period (0-18 months) was informed by Clarity AD, with longer-term progression estimated using external longitudinal data. The model incorporates treatment discontinuation upon progression to moderate AD or institutionalization and captures caregiver quality of life and productivity impacts. Key updates versus the previously presented model at AAN 2025 include: (1) 2026 Canadian cost inputs, (2) caregiver utility estimation using an incremental approach, (3) inclusion of treatment waning scenarios, (4) incorporation of a friction cost approach option for caregiver productivity losses, and (5) incorporation of extended open-label extension data (38- and 48-months). A lifetime horizon and societal perspective were adopted, with costs and outcomes discounted at 1.5% annually.
RESULTS: In the prior base case for the indicated population, lecanemab was associated with gains of 0.86 life-years and 1.70 QALYs, with incremental costs of approximately CAD 80,096, resulting in an ICUR of CAD 47,153 per QALY. The updated ICUR, probabilistic results, and scenario analyses will be presented, reflecting a more decision-relevant assessment aligned with the most recent data and evolving HTA expectations.
CONCLUSIONS: An updated cost-effectiveness model incorporating recent evidence and HTA-driven methodological refinements is needed to accurately assess the value of lecanemab in Canada. These changes strengthen the relevance of economic evidence for healthcare decision-making in early AD.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE56
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
Biologics & Biosimilars, Neurological Disorders