COST-EFFECTIVENESS AND BUDGET IMPACT OF LECANEMAB IN EARLY ALZHEIMER'S DISEASE IN SAUDI ARABIA: A SINGLE-CENTER ANALYSIS AT KING FAHAD MEDICAL CITY
Author(s)
Abdullah Alshehry, PharmD, MBA, BCPS, PhD1, Leena Al-Saeed, Pharm.D, MSc, BCPS2, Amal BinDos, RPh,MHHA2, Hessah AlOtibi, MD2, Fahad A. AlAhmari, PharmD2.
1King Fahd Medical City Hospital Pharmacy, Riyadh, Saudi Arabia, 2King Fahad Medical City, Riyadh, Saudi Arabia.
1King Fahd Medical City Hospital Pharmacy, Riyadh, Saudi Arabia, 2King Fahad Medical City, Riyadh, Saudi Arabia.
OBJECTIVES: This study assessed the cost-effectiveness and 5-year budget impact of lecanemab plus standard of care (SoC) versus SoC alone for adults with mild cognitive impairment or mild dementia due to Alzheimer's disease (AD) with confirmed amyloid-beta pathology, from both a societal and public payer perspective at King Fahad Medical City (KFMC), Saudi Arabia.
METHODS: A Markov cohort model (one-month cycle; half-cycle correction) simulated disease progression across MCI, mild, moderate, and severe AD, and death, with community and institutional care modeled separately over a 30-year lifetime horizon. Clinical inputs were derived from the Clarity AD trial and validated by local experts. Localized costs were sourced from the KFMC Business Center and Electronic Medical Records, including lecanemab acquisition and administration, monitoring, disease management, informal care, and productivity losses. Costs and outcomes were discounted at 3.5%. A willingness-to-pay threshold of 2× Saudi GDP per capita per QALY was applied across both perspectives. A 5-year budget impact analysis modeled a phased eligible population at KFMC (~132-139 patients/year). Univariate, probabilistic, and scenario sensitivity analyses were conducted.
RESULTS: Lecanemab generated 17.05 QALYs versus 14.63 for SoC (incremental gain: 2.42 QALYs) at an incremental cost of SAR 306,429, yielding a base-case ICER of SAR 126,736/QALY—below the threshold of ~SAR 470,078. Probabilistic analysis confirmed robustness (ICER SAR 127,098/QALY). Lecanemab increased time in community settings by 1.35 years. The cumulative 5-year net budget impact at KFMC was SAR 1,968,538, rising from SAR 205,309 (Year 1) to SAR 510,581 (Year 5), partially offset by reduced disease-management costs.
CONCLUSIONS: Lecanemab improved health outcomes and slowed progression of early AD, with an incremental cost-effectiveness ratio considered acceptable under the applied societal willingness-to-pay threshold. These findings support reimbursement consideration of lecanemab and emphasize the need for robust local data.
METHODS: A Markov cohort model (one-month cycle; half-cycle correction) simulated disease progression across MCI, mild, moderate, and severe AD, and death, with community and institutional care modeled separately over a 30-year lifetime horizon. Clinical inputs were derived from the Clarity AD trial and validated by local experts. Localized costs were sourced from the KFMC Business Center and Electronic Medical Records, including lecanemab acquisition and administration, monitoring, disease management, informal care, and productivity losses. Costs and outcomes were discounted at 3.5%. A willingness-to-pay threshold of 2× Saudi GDP per capita per QALY was applied across both perspectives. A 5-year budget impact analysis modeled a phased eligible population at KFMC (~132-139 patients/year). Univariate, probabilistic, and scenario sensitivity analyses were conducted.
RESULTS: Lecanemab generated 17.05 QALYs versus 14.63 for SoC (incremental gain: 2.42 QALYs) at an incremental cost of SAR 306,429, yielding a base-case ICER of SAR 126,736/QALY—below the threshold of ~SAR 470,078. Probabilistic analysis confirmed robustness (ICER SAR 127,098/QALY). Lecanemab increased time in community settings by 1.35 years. The cumulative 5-year net budget impact at KFMC was SAR 1,968,538, rising from SAR 205,309 (Year 1) to SAR 510,581 (Year 5), partially offset by reduced disease-management costs.
CONCLUSIONS: Lecanemab improved health outcomes and slowed progression of early AD, with an incremental cost-effectiveness ratio considered acceptable under the applied societal willingness-to-pay threshold. These findings support reimbursement consideration of lecanemab and emphasize the need for robust local data.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE354
Topic
Economic Evaluation, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Budget Impact Analysis
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas