COST-EFFECTIVENESS OF LECANEMAB IN PATIENTS WITH EARLY ALZHEIMER'SDISEASE IN SAUDI ARABIA
Author(s)
Yasser Albaraka, BSc, MSc, PhD1, Ibtisam H. Alharbi, Sr., PharmD, MSc2, Hana Alabdulkarim, MSc3, Reem Alshammari, PharmD, BCPS4, Leena Al-Saeed, Pharm.D, MSc, BCPS5, Fawaz Al-Ibrahim, MD3, Abdulaziz Alaqil, PharmD4, NAda Alagil, PharmD6, Haitham Elbeltagy, B.Sc. Pharm7, Shaima Khader, MSc8, Muhannad Alharbi, MSc8.
1Ministry of Defense Health Services, Riaydh, Saudi Arabia, 2Ministry of Defense Health Services, Jeddah, Saudi Arabia, 3Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, 4King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, 5King Fahad Medical City, Riaydh, Saudi Arabia, 6Council of Health insurance, Riyadh, Saudi Arabia, 7Eisai, Riyadh, Saudi Arabia, 8HEPA Solutions, Riyadh, Saudi Arabia.
1Ministry of Defense Health Services, Riaydh, Saudi Arabia, 2Ministry of Defense Health Services, Jeddah, Saudi Arabia, 3Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, 4King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, 5King Fahad Medical City, Riaydh, Saudi Arabia, 6Council of Health insurance, Riyadh, Saudi Arabia, 7Eisai, Riyadh, Saudi Arabia, 8HEPA Solutions, Riyadh, Saudi Arabia.
OBJECTIVES: Lecanemab is an anti-amyloid monoclonal antibody approved by the Saudi Food and Drug Authority for adults with early Alzheimer’s disease (AD), including mild cognitive impairment (MCI) or mild dementia due to AD, with confirmed amyloid pathology and no or one APOE4 allele. This study assessed the cost-effectiveness of lecanemab plus standard of care (SoC) versus best supportive care (BSC) from a societal perspective in Saudi Arabia.
METHODS: A Microsoft Excel-based cost-effectiveness model was adapted to the Saudi setting. The model used a Markov cohort structure with health states for MCI due to AD, mild AD, moderate AD, severe AD, and death, with community and institutional care modeled separately over a 30-year lifetime. Costs and outcomes were discounted at 3.5% annually. Transition probabilities were derived from by published evidence from the Clarity AD trial and validated by local experts. Inputs included lecanemab acquisition, administration and monitoring, amyloid-related imaging abnormalities management, diagnosis and confirmatory testing, disease severity-dependent healthcare resource use, non-medical and informal care, and productivity losses. A willingness-to-pay threshold of 2 times the Saudi Arabian GDP per capita per quality-adjusted life-year (QALY) was applied. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: Lecanemab was associated with higher total discounted costs than BSC (255,098 USD vs 173,347 USD), corresponding to an incremental cost of 81,750 USD. It also generated greater health benefits, with 17.05 QALYs versus 14.63 QALYs for BSC, yielding an incremental gain of 2.42 QALYs. The base-case incremental cost-effectiveness ratio (ICER) was 33,811 USD/QALY, which was below the applied willingness-to-pay threshold in Saudi Arabia.
CONCLUSIONS: Lecanemab improved health outcomes andslowed progression of early AD, with an incremental cost-effectiveness ratioconsidered acceptable under the applied Saudi societal willingness-to-paythreshold. These findings support reimbursement consideration of lecanemab andemphasize the need for robust local data.
METHODS: A Microsoft Excel-based cost-effectiveness model was adapted to the Saudi setting. The model used a Markov cohort structure with health states for MCI due to AD, mild AD, moderate AD, severe AD, and death, with community and institutional care modeled separately over a 30-year lifetime. Costs and outcomes were discounted at 3.5% annually. Transition probabilities were derived from by published evidence from the Clarity AD trial and validated by local experts. Inputs included lecanemab acquisition, administration and monitoring, amyloid-related imaging abnormalities management, diagnosis and confirmatory testing, disease severity-dependent healthcare resource use, non-medical and informal care, and productivity losses. A willingness-to-pay threshold of 2 times the Saudi Arabian GDP per capita per quality-adjusted life-year (QALY) was applied. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: Lecanemab was associated with higher total discounted costs than BSC (255,098 USD vs 173,347 USD), corresponding to an incremental cost of 81,750 USD. It also generated greater health benefits, with 17.05 QALYs versus 14.63 QALYs for BSC, yielding an incremental gain of 2.42 QALYs. The base-case incremental cost-effectiveness ratio (ICER) was 33,811 USD/QALY, which was below the applied willingness-to-pay threshold in Saudi Arabia.
CONCLUSIONS: Lecanemab improved health outcomes andslowed progression of early AD, with an incremental cost-effectiveness ratioconsidered acceptable under the applied Saudi societal willingness-to-paythreshold. These findings support reimbursement consideration of lecanemab andemphasize 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
EE513
Topic
Economic Evaluation, Health Technology Assessment, Real World Data & Information Systems
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas