ECONOMIC IMPACT OF A RAPID APOE4 CARRIER TRIAGE STRATEGY FOR ALZHEIMER'S DISEASE: A COST-MINIMIZATION ANALYSIS ACROSS FOUR COUNTRIES
Author(s)
Sophie Roth, MSc1, Celine Coppo, PhD, MsC in Management2, Agathe Hugele, Doctor of Pharmacy (Pharm.D.)3, Alexander Lefevre, MSc4, Milla Mikkola, PhD5.
1Access Evidence Manager, Roche Diagnostics International, Rotkreuz ZG, Switzerland, 2Healthcare Transformation, Market Access, Roche Diagnostics France, Meylan, France, 3Market Access, Roche Diagnostics France, Meylan, France, 4Governmental Affairs & Access, Roche Diagnostics Belgium, Diegem, Belgium, 5Scientific Affairs, Roche Diagnostics Oy, Espoo, Finland.
1Access Evidence Manager, Roche Diagnostics International, Rotkreuz ZG, Switzerland, 2Healthcare Transformation, Market Access, Roche Diagnostics France, Meylan, France, 3Market Access, Roche Diagnostics France, Meylan, France, 4Governmental Affairs & Access, Roche Diagnostics Belgium, Diegem, Belgium, 5Scientific Affairs, Roche Diagnostics Oy, Espoo, Finland.
OBJECTIVES: To evaluate the economic impact of implementing a rapid immunoassay ApoE4 carrier triage strategy compared to direct genotyping for Alzheimer’s Disease patients across three countries (Belgium, Finland, France) using a cost-minimization approach.
METHODS: A cost-minimization model was utilized to compare Strategy 1 (direct genotyping for all patients) against Strategy 2 (carrier triage implementing a rapid immunoassay filter, reserving genotyping only for identified ApoE4 carriers). Country-specific data inputs for cohort sizes, ApoE4 prevalence, medical and lab fees, and resource utilization times were incorporated from published literature, expert opinion and estimates. The French cohort reflects the nationwide target population. The Finnish cohort represents solely the private healthcare sector where patients pay out-of-pocket.
RESULTS: Strategy 2 yielded significant economic savings across all modeled settings. Average per-patient costs (Strategy 1 vs Strategy 2) decreased in Belgium (€362.44 vs €167.25), Finland (€601.00 vs €470.30), and France (€302.78 vs €164.48). Total cohort expenditures were significantly reduced, resulting in system savings of €219,781 in Belgium (N=1,126), €19,605 in the Finnish private sector (N=150), and €52.46 million in France (N=379,278). The carrier triage strategy optimized operational throughput and avoided unnecessary specialist consultation sessions, saving 14,222.93 specialist visits in France and 46.79 in Belgium. Finland’s modeled clinical pathway did not include genetic specialist referrals for ApoE4 carriers, thus no visits were avoided. To maintain economic superiority over Strategy 1, the carrier test price must remain below the break-even thresholds of €223.19 in Belgium, €160.70 in Finland, and €166.30 in France.
CONCLUSIONS: Implementing a rapid ApoE4 carrier triage test is economically superior to direct genotyping in all three settings. This strategy delivers substantial cost savings, reduces laboratory burdens, and optimizes healthcare resource allocation by actively avoiding thousands of unnecessary specialist consultations.
METHODS: A cost-minimization model was utilized to compare Strategy 1 (direct genotyping for all patients) against Strategy 2 (carrier triage implementing a rapid immunoassay filter, reserving genotyping only for identified ApoE4 carriers). Country-specific data inputs for cohort sizes, ApoE4 prevalence, medical and lab fees, and resource utilization times were incorporated from published literature, expert opinion and estimates. The French cohort reflects the nationwide target population. The Finnish cohort represents solely the private healthcare sector where patients pay out-of-pocket.
RESULTS: Strategy 2 yielded significant economic savings across all modeled settings. Average per-patient costs (Strategy 1 vs Strategy 2) decreased in Belgium (€362.44 vs €167.25), Finland (€601.00 vs €470.30), and France (€302.78 vs €164.48). Total cohort expenditures were significantly reduced, resulting in system savings of €219,781 in Belgium (N=1,126), €19,605 in the Finnish private sector (N=150), and €52.46 million in France (N=379,278). The carrier triage strategy optimized operational throughput and avoided unnecessary specialist consultation sessions, saving 14,222.93 specialist visits in France and 46.79 in Belgium. Finland’s modeled clinical pathway did not include genetic specialist referrals for ApoE4 carriers, thus no visits were avoided. To maintain economic superiority over Strategy 1, the carrier test price must remain below the break-even thresholds of €223.19 in Belgium, €160.70 in Finland, and €166.30 in France.
CONCLUSIONS: Implementing a rapid ApoE4 carrier triage test is economically superior to direct genotyping in all three settings. This strategy delivers substantial cost savings, reduces laboratory burdens, and optimizes healthcare resource allocation by actively avoiding thousands of unnecessary specialist consultations.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE669
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
Geriatrics, Neurological Disorders, Personalized & Precision Medicine