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Cost-effectiveness of amyloid-targeting therapies in a memory clinic population; a simulation study
van der Veere P, Broulikova H, Handels R, Teunissen C, Collij L, Vijverberg E, van der Flier W, Berkhof J.. medRxiv, 2026-08-02
Topic: Drug trials: efficacy and safety
Objectives The cost-effectiveness of new amyloid-targeting therapies (ATTs) for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s disease (AD) is influenced by assumptions about treatment effectiveness beyond the trial durations. To assess the cost-effectiveness of ATTs over a lifetime horizon, an AD microsimulation model was applied. Methods The AD microsimulation model is based on statistical joint models, which link cognitive decline (Mini-Mental State Examination [MMSE]) and states of functional independence (MCI, dementia, institutionalisation), fitted to the Amsterdam Dementia Cohort. The time from MCI to death was simulated under care-as-usual (CAU) and two ATT scenarios, assuming an ATT duration of eighteen months and treatment effect waning of 0% (no-waning) or 20% per year. The main outcome was the incremental cost-effectiveness ratio (ICER), defined as incremental costs per quality-adjusted life year (QALY) gained. A societal perspective was taken for costs and effects. Results The ATT scenario without waning resulted in 0.72 additional QALYs and €28,502 additional costs per person compared to CAU. At a list price of €22,600/year for the ATT, the ICER was €39,745/QALY for the no-waning and €151,016/QALY for the 20%-waning scenario. At a willingness-to-pay threshold of €20,000/QALY, the corresponding threshold prices were €10,500 (95% CI: <€0 to €23,000; no-waning) and <€0 (95% CI: <€0 to €2,250; 20%-waning), respectively. Conclusions The cost-effectiveness of ATTs is strongly influenced by the waning of the treatment effect. A favourable cost-effectiveness profile was only achieved when the treatment effect did not wane after the eighteen-month treatment period.
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APA 7th
van der Veere, P., Broulikova, H., Handels, R., Teunissen, C., Collij, L., Vijverberg, E., et al. (2026). Cost-effectiveness of amyloid-targeting therapies in a memory clinic population; a simulation study. medRxiv. https://doi.org/10.64898/2026.07.30.26359218
Vancouver
van der Veere P, Broulikova H, Handels R, Teunissen C, Collij L, Vijverberg E, et al. Cost-effectiveness of amyloid-targeting therapies in a memory clinic population; a simulation study. medRxiv. 2026. doi:10.64898/2026.07.30.26359218.
BibTeX
@article{vanderveere2026-b4afa458,
author = {van der Veere, P. and Broulikova, H. and Handels, R. and Teunissen, C. and Collij, L. and Vijverberg, E. and van der Flier, W. and Berkhof, J.},
title = {{Cost-effectiveness of amyloid-targeting therapies in a memory clinic population; a simulation study}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.07.30.26359218},
url = {https://doi.org/10.64898/2026.07.30.26359218}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results The ATT scenario without waning resulted in 0.72 additional QALYs and €28,502 additional costs per person compared to CAU.
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Study details
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 27 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 17 of the 62 points we could judge it on, which is 27 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 17 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 17 of the 62 points we could judge it on is 27 out of 100. |
| Total | 27 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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