Title:How Much Value Would a Treatment for Alzheimer’s Disease Offer? Cost-Effectiveness Thresholds for Pricing a Disease-Modifying Therapy
VOLUME: 17 ISSUE: 9
Author(s):Hankyung Jun*, Sang K. Cho, Elmar R. Aliyev, Soeren Mattke and Sze-Chuan Suen
Affiliation:Sol Price School of Public Policy, University of Southern California, Los Angeles, CA 90007, University of Houston College of Pharmacy, Houston, TX 77204, School of Pharmacy and Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA 90007, Center for Economic and Social Research, University of Southern California, Los Angeles, CA 90007, Daniel J Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089
Keywords:Alzheimer's disease, dementia, mild cognitive impairment, cost-effectiveness analysis, pricing, drug development,
disease-modifying therapy.
Abstract:
Background: Recent trials suggest that disease-modifying therapy (DMT) for Alzheimer’s
disease may become available soon. With the expected high price and a large patient pool, the budget
impact will be substantial.
Objective: We explore combinations of effectiveness and price under which a DMT is cost-effective.
Methods: We used an open-source model to conduct two-way scenario analyses for both payer and societal
perspectives, varying price, and treatment effect size simultaneously. The analysis generates costeffectiveness
threshold prices over a potential range of DMT effectiveness in patients aged 65+ with
mild cognitive impairment due to Alzheimer’s disease in the US.
Results: Under the willingness-to-pay a threshold of $150,000 per quality-adjusted life year and assuming
30% risk reduction relative to the standard of care, the maximum cost-effective price of a DMT per
patient per year is ~$22,000 and ~$15,000 from societal and payer perspectives, respectively.
Conclusion: Joint variation of price and treatment effect size can help assess the cost-effectiveness of a
potential Alzheimer’s disease treatment.