Estimating the Economically Justifiable Price of Limited-Duration Treatment with Donanemab for Early Symptomatic Alzheimer's Disease in the United States.

Autor: Boustani M; Division of Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA., Doty EG; Lilly Corporate Center, Indianapolis, IN, 46285, USA., Garrison LP Jr; Department of Pharmacy, The CHOICE Institute, University of Washington, Seattle, WA, USA., Smolen LJ; Medical Decision Modeling Inc, Indianapolis, IN, USA., Klein TM; Medical Decision Modeling Inc, Indianapolis, IN, USA., Murphy DR; Medical Decision Modeling Inc, Indianapolis, IN, USA., Spargo AW; Lilly Corporate Center, Indianapolis, IN, 46285, USA., Belger M; Eli Lilly and Company, Bracknell, UK., Johnston JA; Lilly Corporate Center, Indianapolis, IN, 46285, USA. johnston_joseph_a@lilly.com.
Jazyk: angličtina
Zdroj: Neurology and therapy [Neurol Ther] 2024 Dec; Vol. 13 (6), pp. 1641-1659. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1007/s40120-024-00649-y
Abstrakt: Introduction: The goal of this economic model is to estimate an economically justifiable price (EJP) for using donanemab for the treatment of early symptomatic Alzheimer's disease (AD) in the United States based on clinical data from the phase 3 TRAILBLAZER-ALZ 2 trial (NCT04437511).
Methods: We adapted an AD Markov state-transition model developed by the Institute for Clinical and Economic Review to estimate the EJP for donanemab at different willingness-to-pay (WTP) thresholds from the health care system perspective and the societal perspective as co-base cases.
Results: Assuming a WTP threshold of $150,000 per quality-adjusted life-year (QALY) gained, the model estimates a 1-year (13-dose) EJP for donanemab of $80,538 from the health care system perspective and $91,126 from the societal perspective; at a WTP threshold of $100,000 per QALY gained, the model estimates a 1-year (13-dose) EJP for donanemab of $44,691 from the health care system perspective and $55,419 from the societal perspective. Mean total treatment costs per patient at the $150,000 per QALY gained EJP derived from the health care system perspective were estimated at $77,812 based on the average number of doses of donanemab patients received in the co-base case analysis. One-way sensitivity analysis (OWSA) indicated that treatment efficacy, disease severity at the time of treatment initiation, and duration of treatment effect were the main drivers of the potential EJP.
Conclusions: Results from this modeling simulation informed by the TRAILBLAZER-ALZ 2 study support an EJP for limited-duration treatment with donanemab that exceeds per-dose list prices for currently available amyloid-targeting therapies, implying potentially lower lifetime costs and better value for money.
(© 2024. The Author(s).)
Databáze: MEDLINE
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