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治疗阿尔茨海默病的价值有多少?为疾病修正疗法定价的成本效益阈值。

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

机构信息

Sol Price School of Public Policy, University of Southern California, Los Angeles, CA 90007, United States.

University of Houston College of Pharmacy, Houston, TX 77204, United States.

出版信息

Curr Alzheimer Res. 2020;17(9):819-822. doi: 10.2174/1567205017666201203121907.

Abstract

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.

METHODS

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 costeffectiveness 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.

摘要

背景

最近的试验表明,治疗阿尔茨海默病的疾病修正疗法(DMT)可能很快就会问世。考虑到预期的高价格和庞大的患者群体,预算影响将是巨大的。

目的

我们探讨了在何种情况下,DMT 的有效性和价格组合具有成本效益。

方法

我们使用开源模型,从支付方和社会角度同时对价格和治疗效果大小进行双向情景分析。该分析在美国生成了在患有阿尔茨海默病导致轻度认知障碍的 65 岁及以上患者中,DMT 潜在疗效范围内的成本效益阈值价格。

结果

在愿意支付每质量调整生命年 15 万美元的阈值下,并假设与标准护理相比风险降低 30%,从社会和支付方的角度来看,每位患者每年的 DMT 的最大成本效益价格分别约为 22000 美元和 15000 美元。

结论

价格和治疗效果大小的联合变化可以帮助评估潜在阿尔茨海默病治疗的成本效益。

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