A Systematic Review on Economic Evaluations of Disease Modifying Interventions for Alzheimer’s Disease
Author(s)
Kim HS, Cheng SY, Ballreich J
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
Presentation Documents
OBJECTIVES: Disease modifying therapies for Alzheimer’s disease (AD) has the potential to significantly alter the treatment paradigm. However, the clinical potential should pair with appropriate prices to ensure value is delivered. This study reviews current evidence on the economic value of disease modifying treatments for AD. METHODS: We conducted a systematic review of economic evaluation studies of passive immunotherapies or hypothetical disease modifying agents in the treatment of AD. Studies published between January 1st, 2017 and December 31st, 2022 were identified using PubMed and Embase and reviewed by two independent reviewers. Those meeting inclusion criteria were then analyzed for costs, effects, and other relevant economic evaluation parameters such as study perspective. RESULTS: Of the 282 studies that met initial search criteria, eight studies qualified for inclusion. Studies were published between 2019 and 2022 and were all based in the United States. Interventions assessed included aducanumab (four studies), donanemab (one study), lecanemab (one study), and hypothetical disease modifying therapies (DMTs; three studies). The most common perspectives were the healthcare system (six studies) and societal perspective (six studies). Most studies utilized a lifetime horizon (seven studies) and assessed patients ranging between mild and severe AD and. Aducanumab and donanemab were not cost effective at their proposed prices under WTP thresholds between $100,000-150,000. Lecanemab had the potential of being cost-effective with a recommended pricing of $9,249. One DMT resulted in an ICER of $50,542/QALY while another became cost-effective only with the inclusion of caregiver costs and QALYs. Models were most sensitive to changes in drug costs, effectiveness measures, and treatment duration. CONCLUSIONS: Current evidence suggests that current passive immunotherapies are not cost-effective at proposed prices. The large unmet need for AD necessitates further economic evaluation studies to guide the pricing of disease modifying agents.
Conference/Value in Health Info
2023-05, ISPOR 2023, Boston, MA, USA
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EE488
Topic
Economic Evaluation, Study Approaches
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Literature Review & Synthesis
Disease
Biologics & Biosimilars