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New IPECAD Open-Source Model Framework for the Health Technology Assessment of Early Alzheimer's Disease Treatment: Development and Use Cases
Handels Ron, Herring William L, Grimm Sabine, Sköldunger Anders, Winblad Bengt, Wimo Anders, Jönsson Linus. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2024-08-03
Topic: Amyloid, tau and blood-test diagnosis
Reimbursement decisions for new Alzheimer's disease (AD) treatments are informed by economic evaluations. An open-source model with intuitive structure for model cross-validation can support the transparency and credibility of such evaluations. We describe the new International Pharmaco-Economic Collaboration on Alzheimer's Disease (IPECAD) open-source model framework (version 2) for the health-economic evaluation of early AD treatment and use it for cross-validation and addressing uncertainty. A cohort state-transition model using a categorized composite domain (cognition and function) was developed by replicating an existing reference model and testing it for internal validity. Then, features of existing Institute for Clinical and Economic Review (ICER) and Alzheimer's Disease Archimedes Condition-Event Simulator (AD-ACE) models assessing lecanemab treatment were implemented for model cross-validation. Additional uncertainty scenarios were performed on choice of efficacy outcome from trial, natural disease progression, treatment effect waning and stopping rules, and other methodological choices. The model is available open-source as R code, spreadsheet, and web-based version via https://github.com/ronhandels/IPECAD. In the IPECAD model incremental life-years, quality-adjusted life-years (QALY) gains and cost savings were 21% to 31% smaller compared with the ICER model and 36% to 56% smaller compared with the AD-ACE model. IPECAD model results were particularly sensitive to assumptions on treatment effect waning and stopping rules and choice of efficacy outcome from trial. We demonstrated the ability of a new IPECAD open-source model framework for researchers and decision makers to cross-validate other (Health Technology Assessment submission) models and perform additional uncertainty analyses, setting an example for open science in AD decision modeling and supporting important reimbursement decisions.
Key findings
- In the IPECAD model incremental life-years, quality-adjusted life-years (QALY) gains and cost savings were 21% to 31% smaller compared with the ICER model and 36% to 56% smaller compared with the AD-ACE model.
- IPECAD model results were particularly sensitive to assumptions on treatment effect waning and stopping rules and choice of efficacy outcome from trial.
- We demonstrated the ability of a new IPECAD open-source model framework for researchers and decision makers to cross-validate other (Health Technology Assessment submission) models and perform additional uncertainty analyses, setting an example for open science in AD decision modeling and supporting important reimbursement decisions.
Why it matters
This paper describes a new open-source model framework for health-economic evaluation of early Alzheimer's disease treatment, using lecanemab as an example. It does not test any treatment, cure, or prevention, but provides a tool for cross-validating economic models.
Study details
- Evidence strengthModerate
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research) |
| Journal's citation record | 2 / 4 | Value in Health: journal h-index 169 (OpenAlex, 2026-10-29) |
| 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 | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 13 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 13 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Linus Jönsson: h-index 55 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39094686) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.jval.2024.07.009
- PubMed: 39094686
- Original source →
- Free full text: Value in Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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 7 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.
APA 7th
Ron, H., Herring William, L., Sabine, G., Anders, S., Bengt, W., Anders, W., et al. (2025). New IPECAD Open-Source Model Framework for the Health Technology Assessment of Early Alzheimer's Disease Treatment: Development and Use Cases. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. https://doi.org/10.1016/j.jval.2024.07.009
Vancouver
Ron H, Herring William L, Sabine G, Anders S, Bengt W, Anders W, et al. New IPECAD Open-Source Model Framework for the Health Technology Assessment of Early Alzheimer's Disease Treatment: Development and Use Cases. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2025. doi:10.1016/j.jval.2024.07.009. PMID: 39094686.
BibTeX
@article{ron2025-39094686,
author = {Ron, Handels and Herring William, L. and Sabine, Grimm and Anders, Sköldunger and Bengt, Winblad and Anders, Wimo and Linus, Jönsson},
title = {{New IPECAD Open-Source Model Framework for the Health Technology Assessment of Early Alzheimer's Disease Treatment: Development and Use Cases}},
journal = {Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research},
year = {2025},
doi = {10.1016/j.jval.2024.07.009},
pmid = {39094686},
url = {https://doi.org/10.1016/j.jval.2024.07.009}
}
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