How Much Value Would a Treatment for Alzheimer’s Disease Offer? Cost-Effectiveness Thresholds for Pricing a Disease-Modifying Therapy

2020 ◽  
Vol 17 ◽  
Author(s):  
Hankyung Jun ◽  
Sang Kyu Cho ◽  
Elmar R. Aliyev ◽  
Soeren Mattke ◽  
Sze-Chuan Suen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Treatment Effect ◽  
Effect Size ◽  
Cost Effective ◽  
High Price ◽  
Disease Modifying Therapy ◽  
Treatment Effect Size ◽  
Disease Modifying

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. Method: 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 cost-effectiveness 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.

scholarly journals Neurotrophins and Neurotrophic Therapy (Based on the Cerebrolysin Model) in the Treatment of Elderly Patients with Cognitive Disorders and Depression. Part 1

Psychiatry ◽  
2021 ◽  
Vol 19 (2) ◽  
pp. 87-103
Author(s):  
S. I. Gavrilova ◽  
T. P. Safarova
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Disorders ◽  
Disease Modifying Therapy ◽  
Global Priority ◽  
Disease Modifying ◽  
Preclinical And Clinical Studies ◽  
Neurotrophic Therapy ◽  
Global Health Problem ◽  
Neurotrophic Action

Background: Alzheimer’s disease (AD) is the most common neurocognitive disorder and a global health problem. The prevalence of AD is increasing dramatically, and will double in two decades to reach 100 million cases worldwide. Therefore, the development of disease-modifying therapies that can delay or even prevent the onset and progression of AD has become a global priority.Objective: to present a review of domestic and foreign modern studies covering the pathogenesis of AD and disease-modifying therapy.Material and methods: the keywords “Alzheimer’s disease, late age, mild cognitive impairment, depression, therapy, cerebrolysin, effectiveness” were used to search for scientifi c articles in MEDLINE and PUBMED databases for the period 1980–2020.Results and conclusions: since the pathophysiology of AD is multifactorial, it is not surprising that all attempts to change the course of the disease with drugs aimed at a single therapeutic goal were unsuccessful. Thus, combined multimodal therapy using several drugs with a single mechanism of action or multi-purpose drugs seems to be the most promising strategy for both effective therapy of AD and its prevention. Cerebrolysin, acting as a multimodal peptidergic drug with a proven neurotrophic effect, has not only an immediate therapeutic effect on AD, which may refl ect its potential benefi t for modifying the course of the disease. Numerous clinical trials have shown that cerebrolysin is safe and effective in the treatment of AD, and can also enhance and prolong the effectiveness of cholinergic drugs, especially in patients with moderate AD. In this review, we summarize the achievements in the study of the therapeutic signifi cance of the drug and its effect on the pathogenesis of AD, paying special attention to the mechanisms of neurotrophic action. The review presents the results of both preclinical and clinical studies of cerebrolysin in the treatment of AD and pre-dementia cognitive disorders, as well as late depression.

scholarly journals Good problems to have? Policy and societal implications of a disease-modifying therapy for presymptomatic late-onset Alzheimer’s disease

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Misha Angrist ◽  
Anna Yang ◽  
Boris Kantor ◽  
Ornit Chiba-Falek
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Gene Editing ◽  
Late Onset ◽  
The United States ◽  
Societal Implications ◽  
Track Record ◽  
Disease Modifying Therapy ◽  
The Us ◽  
Disease Modifying

Abstract In the United States alone, the prevalence of AD is expected to more than double from six million people in 2019 to nearly 14 million people in 2050. Meanwhile, the track record for developing treatments for AD has been marked by decades of failure. But recent progress in genetics, neuroscience and gene editing suggest that effective treatments could be on the horizon. The arrival of such treatments would have profound implications for the way we diagnose, triage, study, and allocate resources to Alzheimer’s patients. Because the disease is not rare and because it strikes late in life, the development of therapies that are expensive and efficacious but less than cures, will pose particular challenges to healthcare infrastructure. We have a window of time during which we can begin to anticipate just, equitable and salutary ways to accommodate a disease-modifying therapy Alzheimer’s disease. Here we consider the implications for caregivers, clinicians, researchers, and the US healthcare system of the availability of an expensive, presymptomatic treatment for a common late-onset neurodegenerative disease for which diagnosis can be difficult.

“To Treat or not To Treat”: Informing the Decision for Disease-Modifying Therapy in Late-Stage Alzheimer’s Disease

2019 ◽  
Vol 68 (4) ◽  
pp. 1321-1323 ◽  
Author(s):  
Andrew D. Watt ◽  
Nicole L. Jenkins ◽  
Gawain McColl ◽  
Steven Collins ◽  
Patricia M. Desmond
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Late Stage ◽  
Disease Modifying Therapy ◽  
Disease Modifying
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