Health‐economic innovation headroom in mild cognitive impairment due to Alzheimer’s diseas

Background Estimating health-economic impact of new therapies for prodromal Alzheimer’s disease (AD) requires extrapolating short-term effects on surrogate markers efficacy to long-term clinically relevant outcomes. This assumptions the nature treatment (symptomatic versus disease-modifying) and depends target population (which varies in progression associated biological subtypes). We aim estimate innovation headroom (potential value) AD mild cognitive impairment (MCI), describe (symptomatic/disease-modifying) (fast/slow progressors), discuss challenges evaluation future treatments; ensure patients timely access innovations. Method The IPECAD open-source decision-analytic model was used estimating time spent with MCI, mild, moderate severe dementia, discounted quality-adjusted life years (QALYs) costs, under different strategies. Innovation estimated by simulating a usual care strategy, compare it strategy reflecting fictive disease-modifying 100% efficacy, efficacious symptomatic therapy; preventing all individuals progress dementia. Result analysis resulted 4.1 additional QALYs k€13 lower costs disease-modifying, 0.8 k€71 therapy. higher QALY gain disease-modification is mainly explained an indirect effect mortality, resulting 5.5 year increase expectancy. about twice as large persons fast compared slow MCI. therapy generated improved health (QALY gains), while savings care; which contingent their mortality assumptions. Conclusion potential economic benefit (non-)pharmacological interventions MCI substantial. However, its dependency related argues research efforts better understand relation between Its indicates individualized based profiles progression. Finally, we recommend incorporating age-related comorbidities result relatively gained.