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Understanding Cost-Effectiveness of Limited Duration Dosing of Therapy for Alzheimer’s disease

January 13, 2023    Posted by: Eli Lilly and Company

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Title of the Study: Assessing the Cost-effectiveness of a Hypothetical Disease-Modifying Therapy with Limited Duration for the Treatment of Early Symptomatic Alzheimer's Disease

Why was this study done?

The purpose of this study was to understand how the cost-effectiveness of a therapy for Alzheimer’s disease (AD) might vary depending on the length of time a patient needs to receive treatment. In this case, the researchers examined a hypothetical therapy that works by clearing the toxic protein buildup (amyloid plaque) associated with the disease.

In this study, the hypothetical therapy had a distinct stopping point and provided patients with benefit even when the course of treatment was over, as opposed to other treatments that must be taken continuously. The ability to stop treatment and still receive a benefit is expected to have an impact on cost-effectiveness, which was further examined in this study.

How was the study conducted?

Researchers developed a model that maps the progression of AD patients through 5 disease stages across community and long-term care settings. The model uses the quality-adjusted life year (QALY). That concept accounts for improvements in both length of life and quality of life as a measurement of the treatment value.

The model compared the cost-effectiveness of the hypothetical therapy paired with supportive care—both non-drug and with drugs that address symptoms only—versus supportive care alone. It looked at Americans living with mild cognitive impairment or mild dementia due to AD and accounts for multiple perspectives.

  • The health care sector perspective: considers only the benefit to patients and the costs that affect the patient and the health care system (ex: treatment, administration, long-term care, and patient direct medical costs).

  • The modified societal perspective: also considers benefits to caregivers and costs beyond the health care sector. That includes medical costs of the informal caregiver and productivity costs of both the patient and the informal caregiver.

Treatment costs were calculated under three treatment strategies at an annual drug cost of either $56,000 or $28,000:

  1. Continuous treatment

  2. Fixed-duration treatment for 18 months

  3. Test and discontinue treatment, where some patients are able to stop treatment even sooner than 18 months

What did the study find?

This study found that therapies with a limited duration of use and ongoing medical benefits had the potential to deliver good value for the money. The effectiveness and duration of the treatment benefit are important characteristics that influence just how much value is delivered at a given treatment cost.Over time, as more research is conducted, the ability to estimate more precisely the cost-effectiveness of available AD treatments should improve.

Access the full published paper here.