The Cost-Effective Price of Lecanemab for Patients with Early Alzheimer’s Disease in Sweden

Introduction We sought to estimate the cost-effective price for lecanemab for treating early Alzheimer’s disease in Sweden from the perspective of formal care payers. Methods We developed a Markov model with states defined by disease severity and care setting. The model was populated by integrated clinical and economic data from Swedish registers. We included patients with biomarker-confirmed Alzheimer’s disease and fitted survival models for transitions between model states. Costs in 2023 Swedish kronor (SEK), life-years (LYs), and quality-adjusted LYs (QALYs) over a 10-year time horizon were estimated for standard of care and for lecanemab in addition to standard of care, assuming a maximum treatment duration of 3 years with lecanemab and no treatment effect after treatment stops. We also explored the impact of different assumptions regarding treatment efficacy and duration. Results Treatment with lecanemab over 3 years resulted in 0.13 LYs gained, 0.17 QALYs gained, and a net cost increase of 87,146 SEK (€1 = 11.5 SEK, $US1 = 10.6 SEK) due to administration and monitoring, before considering the cost of drug. The cost-effective price of lecanemab at a willingness-to-pay level of 1 million SEK per QALY was 33,886 SEK per year of treatment. The health gain, net costs, and cost-effective price of lecanemab varied significantly by treatment duration, potential residual effects, and patient characteristics. Conclusions The future price of lecanemab in European countries is unknown. However, treatment with lecanemab is unlikely to be cost effective in Sweden at the levels of current list prices in the USA.