Evaluating the Transition from Intravenous to Subcutaneous Formulations: A Cost-Comparison Model for Early Alzheimer's Disease
Author(s)
Lindsey Fox, PhD1, William L. Herring, PhD1, Stephanie Barrows, MA, MPH1, Quan Zhang, PhD2, Amir A. Tahami Monfared, PhD, MD2;
1RTI Health Solutions, Research Triangle Park, NC, USA, 2Eisai Inc., Nutley, NJ, USA
1RTI Health Solutions, Research Triangle Park, NC, USA, 2Eisai Inc., Nutley, NJ, USA
OBJECTIVES: Medications administered via intravenous (IV) infusion can be burdensome and costly for payers, providers, patients, and caregivers. Transitioning from a weight-based IV formulation to a fixed-dose subcutaneous (SC) formulation may improve convenience, enhance outcomes, and reduce societal costs. This study aimed to estimate the potential cost implications of IV versus SC administration of lecanemab for early Alzheimer’s disease (AD) in the United States.
METHODS: A targeted literature review was conducted to identify outcomes related to IV and SC (IV/SC) modes of administration across therapeutic areas to inform and parameterize a cost-comparison model. The model considered direct treatment costs, economic value of administration time (providers, patients, caregivers), and quality-of-life (QOL) impacts (patients, caregivers). Cost outcomes were estimated from a societal perspective over 3 years, including a head-to-head comparison of IV/SC regimens and a population-level analysis accounting for population size, treatment rates, and SC uptake. Scenario analyses examined the influence of key inputs and settings on cost impacts.
RESULTS: Transitioning to an SC formulation of lecanemab was estimated to save $55,778 per treated patient over 3 years, with average annual savings of $18,593 per patient. Savings included reductions of $30,474, $6,388, and $18,916 in treatment, administration time, and QOL costs, respectively. At the population level, using reported treatment rates and assuming 49.4% SC uptake, these savings scaled to approximately $2.44 billion over 3 years. Sensitivity analyses revealed that savings per patient were influenced by site of care, drug wastage for IV administration, caregiver disutilities, and willingness-to-pay thresholds. Population-level outcomes were sensitive to treatment rates and SC uptake.
CONCLUSIONS: Subcutaneous administration of lecanemab potentially offers substantial cost-savings from a societal perspective, reducing treatment, time, and QOL-associated costs for both patients and caregivers. These findings underscore the potential value of SC formulations in improving treatment delivery and mitigating the economic burden of AD.
METHODS: A targeted literature review was conducted to identify outcomes related to IV and SC (IV/SC) modes of administration across therapeutic areas to inform and parameterize a cost-comparison model. The model considered direct treatment costs, economic value of administration time (providers, patients, caregivers), and quality-of-life (QOL) impacts (patients, caregivers). Cost outcomes were estimated from a societal perspective over 3 years, including a head-to-head comparison of IV/SC regimens and a population-level analysis accounting for population size, treatment rates, and SC uptake. Scenario analyses examined the influence of key inputs and settings on cost impacts.
RESULTS: Transitioning to an SC formulation of lecanemab was estimated to save $55,778 per treated patient over 3 years, with average annual savings of $18,593 per patient. Savings included reductions of $30,474, $6,388, and $18,916 in treatment, administration time, and QOL costs, respectively. At the population level, using reported treatment rates and assuming 49.4% SC uptake, these savings scaled to approximately $2.44 billion over 3 years. Sensitivity analyses revealed that savings per patient were influenced by site of care, drug wastage for IV administration, caregiver disutilities, and willingness-to-pay thresholds. Population-level outcomes were sensitive to treatment rates and SC uptake.
CONCLUSIONS: Subcutaneous administration of lecanemab potentially offers substantial cost-savings from a societal perspective, reducing treatment, time, and QOL-associated costs for both patients and caregivers. These findings underscore the potential value of SC formulations in improving treatment delivery and mitigating the economic burden of AD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE218
Topic
Economic Evaluation
Disease
SDC: Neurological Disorders