ECONOMIC VALUE OF SUBCUTANEOUS VERSUS INTRAVENOUS LECANEMAB IN EARLY ALZHEIMER'S DISEASE: A COST-BENEFIT ANALYSIS FROM A SOCIETAL PERSPECTIVE IN JAPAN
Author(s)
Ataru Igarashi, PhD1, Mie Kasai Azuma, MSc, RPh, PhD2, Mayaka Tani, MPH2, Hidetoshi Shibahara, PhD3, Kiyoyuki Tomita, MMA2.
1Graduate School of Business Administration, Keio University, Yokohama, Japan, 2Eisai Co., Ltd., Tokyo, Japan, 3CRECON MEDICAL ASSESSMENT INC., Tokyo, Japan.
1Graduate School of Business Administration, Keio University, Yokohama, Japan, 2Eisai Co., Ltd., Tokyo, Japan, 3CRECON MEDICAL ASSESSMENT INC., Tokyo, Japan.
OBJECTIVES: This study estimated the economic value and societal cost implications of introducing a subcutaneous (SC) lecanemab formulation compared with the intravenous (IV) formulation alone for the treatment of early Alzheimer’s disease (AD).
METHODS: A cost-benefit model was developed over a 4-year time horizon from a societal perspective. Baseline population parameters were derived from the lecanemab IV post-marketing all-case surveillance in Japan, evaluating 5,245 early AD patients (64.4% mild cognitive impairment due to AD and 35.6% mild AD dementia). The SC introduction scenario (70% SC uptake) was compared with the baseline scenario (100% IV). Evaluated societal costs included direct medical costs (comprising drug and administration fees, and medical resource use), monetization of administration-related time for healthcare providers, patients, and caregivers, and quality-of-life (QOL) impacts for patients and caregivers. To evaluate QOL impacts, patient disutilities associated with each administration route were estimated from a discrete choice experiment study and monetized using benchmark thresholds ranging from JPY 5.0 to 15.0 million per quality-adjusted life-year.
RESULTS: Assuming equal daily drug costs, introducing SC lecanemab over 4 years showed total societal savings ranging from JPY 10.1 to 21.0 billion, or JPY 1.9 to 4.0 million per patient. Specifically, these reductions included JPY 57,370 for direct medical costs and JPY 0.8 million for human resource costs associated with administration-related activities. Additionally, QOL impacts yielded further savings ranging from JPY 1.0 to 3.1 million. Even with SC drug price premiums of 5% and 10%, per-patient savings of JPY 1.6 to 3.7 million and JPY 1.4 to 3.4 million, respectively, were maintained across the evaluated range.
CONCLUSIONS: Incorporating an SC lecanemab formulation into early AD care in Japan could yield substantial societal cost savings. Shifting from biweekly IV infusions at clinics to weekly at-home SC injections reduces treatment-related time and QOL impacts for patients and caregivers while optimizing healthcare resource utilization.
METHODS: A cost-benefit model was developed over a 4-year time horizon from a societal perspective. Baseline population parameters were derived from the lecanemab IV post-marketing all-case surveillance in Japan, evaluating 5,245 early AD patients (64.4% mild cognitive impairment due to AD and 35.6% mild AD dementia). The SC introduction scenario (70% SC uptake) was compared with the baseline scenario (100% IV). Evaluated societal costs included direct medical costs (comprising drug and administration fees, and medical resource use), monetization of administration-related time for healthcare providers, patients, and caregivers, and quality-of-life (QOL) impacts for patients and caregivers. To evaluate QOL impacts, patient disutilities associated with each administration route were estimated from a discrete choice experiment study and monetized using benchmark thresholds ranging from JPY 5.0 to 15.0 million per quality-adjusted life-year.
RESULTS: Assuming equal daily drug costs, introducing SC lecanemab over 4 years showed total societal savings ranging from JPY 10.1 to 21.0 billion, or JPY 1.9 to 4.0 million per patient. Specifically, these reductions included JPY 57,370 for direct medical costs and JPY 0.8 million for human resource costs associated with administration-related activities. Additionally, QOL impacts yielded further savings ranging from JPY 1.0 to 3.1 million. Even with SC drug price premiums of 5% and 10%, per-patient savings of JPY 1.6 to 3.7 million and JPY 1.4 to 3.4 million, respectively, were maintained across the evaluated range.
CONCLUSIONS: Incorporating an SC lecanemab formulation into early AD care in Japan could yield substantial societal cost savings. Shifting from biweekly IV infusions at clinics to weekly at-home SC injections reduces treatment-related time and QOL impacts for patients and caregivers while optimizing healthcare resource utilization.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE662
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies
Disease
Biologics & Biosimilars, Geriatrics, Neurological Disorders