Background: Studies on the immunotherapy for Alzheimer’s disease (AD) have increasingly
gained attention since 1990s. However, there are pros (preventing of AD) and cons (incurred
cost and side effects) regarding the administration of immunotherapy. Up to date, there has been lacking
of economic evaluation for immunotherapy of AD. We aimed to assess the cost-effectiveness
analysis of the vaccination for AD. Methods: A meta-analysis of randomized control trials after systemic
review was conducted to evaluate the efficacy of the vaccine. A Markov decision model was
constructed and applied to a 120,000-Taiwanese cohort aged ≥65 years. Person years and quality-adjusted life years
(QALY) were computed between the vaccinated group and the the unvaccinated group. Economic evaluation was performed
to calculate the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curve (CEAC).
Results: Vaccinated group gained an additional 0.84 life years and 0.56 QALYs over 10-years and an additional 0.35 life
years and 0.282 QALYs over 5-years of follow-up. The vaccinated group dominated the unvaccinated group by ICER
over 5-years of follow-up. The ICERs of 10-year follow-up for the vaccinated group against the unvaccinated group were
$13,850 per QALY and $9,038 per life year gained. Given the threshold of $20,000 of willingness to pay (WTP), the
CEAC showed the probability of being cost-effective for vaccination with QALY was 70.7% and 92% for life years
gained after 10-years of follow-up. The corresponding figures were 87.3% for QALY and 93.5% for life years gained over
5-years follow-up. Conclusion: The vaccination for AD was cost-effective in gaining QALY and life years compared
with no vaccination, under the condition of a reasonable threshold of WTP.
Keywords: Alzheimer's disease, cost-effectiveness analysis, immunotherapy, meta-analysis, vaccination.
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