Cost-effectiveness of aducanumab to prevent Alzheimer's disease progression at current list price

Alzheimers Dement (N Y). 2022 Mar 7;8(1):e12256. doi: 10.1002/trc2.12256. eCollection 2022.

Abstract

Introduction: An estimated 6 million Americans have Alzheimer's disease (AD). Aducanumab was recently approved by the Food and Drug Administration despite the lack of clinical effectiveness data.

Methods: We developed a Markov state transition model of AD to estimate the cost effectiveness of aducanumab compared to standard of care (SOC) over a 5-year time horizon for a cohort of persons aged 65 with mild AD. Outcomes included quality adjusted life years (QALYs), discounted costs, and incremental cost-effectiveness ratios (ICERs). We performed sensitivity analyses to address uncertainty.

Results: Over 5 years, the incremental cost of aducanumab compared to SOC was $179,890. Aducanumab resulted in 0.47 QALYs gained compared to SOC. The ICER for aducanumab compared to SOC was $383,080/QALY. In threshold analysis, aducanumab became cost-effective at $22,820/year.

Discussion: Aducanumab is not cost-effective at the estimated price of $56,000 even under ideal circumstances in which it completely halts AD progression.

Keywords: Alzheimer's disease; aducanumab; cost‐effectiveness; dementia.