Dataset Information

Predicting the Societal Value of Lecanemab in Early Alzheimer's Disease in Japan: A Patient-Level Simulation.

ABSTRACT:

Introduction

Alzheimer's disease (AD), a neurodegenerative disorder that progresses from mild cognitive impairment (MCI) to dementia, is responsible for significant burden on caregivers and healthcare systems. In this study, data from the large phase III CLARITY AD trial were used to estimate the societal value of lecanemab plus standard of care (SoC) versus SoC alone against a range of willingness-to-pay (WTP) thresholds from a healthcare and societal perspective in Japan.

Methods

A disease simulation model was used to evaluate the impact of lecanemab on disease progression in early AD based on data from the phase III CLARITY AD trial and published literature. The model used a series of predictive risk equations based on clinical and biomarker data from the Alzheimer's Disease Neuroimaging Initiative and Assessment of Health Economics in Alzheimer's Disease II study. The model predicted key patient outcomes, including life years (LYs), quality-adjusted life years (QALYs), and total healthcare and informal costs of patients and caregivers.

Results

Over a lifetime horizon, patients treated with lecanemab plus SoC gained an additional 0.73 LYs compared with SoC alone (8.50 years vs. 7.77 years). Lecanemab, with an average treatment duration of 3.68 years, was found to be associated with a 0.91 increase in patient QALYs and a total increase of 0.96 when accounting for caregiver utility. The estimated value of lecanemab varied according to the WTP thresholds (JPY 5-15 million per QALY gained) and the perspective employed. From the narrow healthcare payer's perspective, it ranged from JPY 1,331,305 to JPY 3,939,399. From the broader healthcare payer's perspective, it ranged from JPY 1,636,827 to JPY 4,249,702, while from the societal perspective, it ranged from JPY 1,938,740 to JPY 4,675,818.

Conclusion

The use of lecanemab plus SoC would improve health and humanistic outcomes with reduced economic burden for patients and caregivers with early AD in Japan.

SUBMITTER: Igarashi A

PROVIDER: S-EPMC10310671 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Predicting the Societal Value of Lecanemab in Early Alzheimer's Disease in Japan: A Patient-Level Simulation.

Igarashi Ataru A Azuma Mie Kasai MK Zhang Quanwu Q Ye Weicheng W Sardesai Aditya A Folse Henri H Chavan Ameya A Tomita Kiyoyuki K Tahami Monfared Amir Abbas AA

Neurology and therapy 20230515 4

<h4>Introduction</h4>Alzheimer's disease (AD), a neurodegenerative disorder that progresses from mild cognitive impairment (MCI) to dementia, is responsible for significant burden on caregivers and healthcare systems. In this study, data from the large phase III CLARITY AD trial were used to estimate the societal value of lecanemab plus standard of care (SoC) versus SoC alone against a range of willingness-to-pay (WTP) thresholds from a healthcare and societal perspective in Japan.<h4>Methods</h ...[more]

PMID: 37188886

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Project description:IntroductionAlzheimer's disease (AD) is a progressive neurodegenerative disorder associated with memory, cognitive, and behavioral deficits, and brings significant economic burden on caregivers and healthcare systems. This study aims to estimate the long-term societal value of lecanemab plus standard of care (SoC) versus SoC alone, corresponding to a range of willingness-to-pay (WTP) thresholds based on the phase III CLARITY AD trial readouts from both the US payer and societal perspectives.MethodsAn evidence-based model was developed to simulate the effects of lecanemab on disease progression in early AD using interconnected predictive equations based on longitudinal clinical and biomarker data derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI). The model was informed with the results of the phase III CLARITY AD trial and published literature. Key model outcomes included patient life-years (LYs), quality-adjusted life-years (QALYs), and total costs of both the direct and indirect costs of patients and caregivers over a lifetime horizon.ResultsPatients treated with lecanemab plus SoC gained an additional 0.62 years of life versus SoC alone (6.23 years vs. 5.61 years). The mean time on lecanemab was 3.91 years, and the treatment was associated with an increase in patient QALYs of 0.61 and an increase in total QALYs of 0.64 when both patient and caregiver utilities were considered. The model estimated that the annual value of lecanemab for the US payer perspective was US$18,709-35,678 ($19,710-37,351 for societal perspective) at the WTP threshold of $100,000-200,000 per QALY gained, respectively. Scenario analyses of patient subgroups, time horizon, input sources, treatment stopping rules, and treatment dosing were conducted to explore the impact of alternative assumptions on the model results.ConclusionThe economic study suggested that lecanemab plus SoC would improve health and humanistic (quality of life) outcomes and reduce economic burden for patients and caregivers in early AD.

Project description:A significant proportion of all deaths globally can be attributed to alcohol consumption. Although a range of correlates of alcohol consumption have already been identified at the individual level, less is understood about correlates at the macro level, such as cultural values. As a development in this understanding may prove useful for global health organizations aiming to tackle the problems associated with excessive drinking, our aim was to investigate the association between encultured alcohol consumption and Cultural Value Orientations. We obtained data describing average alcohol consumption and Cultural Value Orientations, for 74 countries, from an online data repository. To assess whether Cultural Value Orientations are associated with alcohol consumption we calculated partial correlations and performed a ridge regression analysis. Our analyses revealed that Cultural Value Orientations were significantly associated with alcohol consumption, even after controlling for average income and education level. A profile emerged in which values of autonomy and harmony were shown to be positively associated with alcohol consumption, and hierarchy and embeddedness negatively associated with alcohol consumption. The effect was modified by gender. Changes in cultural Harmony, Mastery, Autonomy and Egalitarianism were associated with increases in alcohol consumption in males, but not females, while changes in cultural Embeddedness and Hierarchy were associated with decreases in consumption in females, but no change in males. Finally, we demonstrate that latitude, and by extension its covariates such as climatic demands, partially accounted for the effect of harmony and affective autonomy on alcohol consumption. This research highlights that cultural values, and their interaction with gender, should be an important consideration for international public health organizations aiming to tackle the problems associated with alcohol consumption, but that future research is required to fully understand the link between cultural values and alcohol.

Project description:IntroductionAlzheimer's disease (AD), a progressive neurodegenerative disease, is the main cause of dementia and one of the leading causes of death for elderly people in the USA. Lecanemab is a humanized IgG1 monoclonal antibody targeting amyloid protofibrils for the treatment of early AD [i.e., mild cognitive impairment (MCI) or mild AD dementia]. In a recent 18-month phase III trial, using a double-blind, placebo-controlled design, lecanemab treatment led to reduced brain amyloid burden and significant improvements in cognitive and functional abilities in individuals with early AD.MethodsAn evidence-based patient-level disease simulation model was updated to estimate the long-term health outcomes of lecanemab plus standard of care (SoC) compared to SoC alone in patients with early AD and evidence of brain amyloid burden, using recent phase III trial data and published literature. The disease progression is described by changes in the underlying biomarkers of AD, including measures of amyloid and tau, and their connection to the clinical presentation of the disease assessed through various patient-level scales of cognition and function.ResultsLecanemab treatment was estimated to slow the progression of AD to moderate and severe stages and reduce the time spent in these more advanced states. In individuals with early AD, lecanemab plus SoC was associated with a gain of 0.71 quality-adjusted life-years (QALYs), a 2.95-year delay in mean time to progression to AD dementia, a reduction of 0.11 years in institutional care, and an additional 1.07 years in community care as shown in the base-case study. Improved health outcomes were demonstrated with lecanemab treatment when initiated earlier based on age, disease severity, or tau pathology, resulting in estimated gains in QALYs ranging from 0.77 to 1.09 years, compared to 0.4 years in the mild AD dementia subset, as shown by the model.ConclusionThe study findings demonstrate the potential clinical value of lecanemab for individuals with early AD by slowing down disease progression and prolonging time in earlier stages of disease, which significantly benefits not only patients and caregivers but also society overall.Trial registrationClinicalTrials.gov identifier, NCT03887455.

Project description:ObjectivesThere is inadequate information on the economic burden of hypertension treatment in Ethiopia. Therefore, this study was conducted to determine the societal economic burden of hypertension at selected hospitals in Southern Ethiopia.MethodsPrevalence-based cost of illness study from a societal perspective was conducted. Disability-adjusted life years (DALYs) were determined by the current WHO's recommended DALY valuation method. Adjustment for comorbidity and a 3% discount was done for DALYs. The data entry, processing and analysis were done by using SPSS V.21.0 and Microsoft Excel V.2013.ResultsWe followed a cohort of 406 adult patients with hypertension retrospectively for 10 years from September 2010 to 2020. Two hundred and fifty (61.6%) of patients were women with a mean age of 55.87±11.03 years. Less than 1 in five 75 (18.5%) of patients achieved their blood pressure control target. A total of US$64 837.48 direct cost was incurred due to hypertension. A total of 11 585 years and 579.57 years were lost due to hypertension-related premature mortality and morbidity, respectively. Treated and uncontrolled hypertension accounted for 50.83% (6027) of total years lost due to premature mortality from treated hypertension cohort. Total productivity loss due to premature mortality and morbidity was US$449 394.69. The overall economic burden of hypertension was US$514 232.16 (US$105.55 per person per month).ConclusionSocietal economic burden of hypertension in Southern Ethiopia was substantial. Indirect costs accounted for more than 8 out of 10 dollars. Treated and uncontrolled hypertension took the lion's share of economic cost and productivity loss due to premature mortality and morbidity. Therefore, designing and implanting strategies for the prevention of hypertension, early screening and detection, and improving the rate of blood pressure control by involving all relevant stakeholders at all levels is critical to saving scarce health resources.

Dataset Information

Predicting the Societal Value of Lecanemab in Early Alzheimer's Disease in Japan: A Patient-Level Simulation.

Introduction

Methods

Results

Conclusion

Publications

Predicting the Societal Value of Lecanemab in Early Alzheimer's Disease in Japan: A Patient-Level Simulation.

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