PND25 HOW MUCH VALUE SHOULD A PREVENTIVE TREATMENT FOR ALZHEIMER'S DISEASE OFFER? COST-EFFECTIVENESS THRESHOLDS FOR PRICING A DISEASE-MODIFYING THERAPY

Abstract

Recently published trial results suggest that a disease-modifying therapy (DMT) for Alzheimer’s disease (AD) might become available soon. With the expected high price and a large patient pool, the budget impact will be substantial. We explore the combinations of effect size and price under which a DMT would be cost-effective. We use an established, open-source model of disease progression to conduct two-way scenario analyses, varying price and effect sizes simultaneously. The analysis generates cost-effectiveness threshold prices, if a DMT were used in patients age 65+ with mild cognitive impairment due to AD in the United States, over a potential range of DMT effectiveness. We apply a payer and societal perspective. Under the willingness-to-pay threshold of $150,000 per QALY and assuming 20% risk reduction relative to standard of care, the maximum cost-effective price of a DMT per patient year is around $14,500 from a societal perspective and $10,000 from a payer perspective. This study provides a framework to understand the value of a potential AD treatment, as the contours of effect size and price become clearer. This may be useful for policymakers seeking to weigh the tradeoffs between treatment price and effectiveness within their own policy context.