Cost‐effectiveness and impact at scale of collaborative care and lecanemab for Alzheimer's disease

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Abstract INTRODUCTION Advancements in disease‐modifying therapies and collaborative dementia care programs have created opportunities to transform care for people with Alzheimer's disease. METHODS We modeled people aged 71 across three scenarios: 18 months of lecanemab, collaborative care, and combined interventions. Outcomes included quality‐adjusted life years (QALYs), 2024 costs, and incremental cost‐effectiveness ratios (ICERs) as appropriate. RESULTS Per person, collaborative care (vs usual care) increased QALYs by 0.26 with savings of $48,000 (dominant); adding lecanemab to collaborative care yielded an additional 0.16 QALYs at a total cost per QALY of $218,000 (societal perspective) and $248,000 (healthcare perspective). When scaled to the US population, lecanemab yielded 180,000 QALYs at a cost of $39.5 billion; collaborative care yielded 1.5 million QALYs and saved $300 billion. Findings were robust to uncertainties. DISCUSSION Collaborative dementia care offers health and economic benefits and should be prioritized for widespread implementation.

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