The value of maintaining cognition in patients with mild cognitive impairment: The innovation headroom and potential cost-effectiveness of roflumilast

Ron Handels; Sabine Grimm; Arjan Blokland; Nina Possemis; Inez Ramakers; Anke Sambeth; Frans Verhey; Stephanie Vos; Manuela Joore; Jos Prickaerts; Linus Jönsson

doi:10.1002/alz.13001

The value of maintaining cognition in patients with mild cognitive impairment: The innovation headroom and potential cost-effectiveness of roflumilast

Ron Handels^*, Sabine Grimm, Arjan Blokland, Nina Possemis, Inez Ramakers, Anke Sambeth, Frans Verhey, Stephanie Vos, Manuela Joore, Jos Prickaerts, Linus Jönsson

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

INTRODUCTION: Early health-technology assessment can support discussing scarce resource allocation among stakeholders. We explored the value of maintaining cognition in patients with mild cognitive impairment (MCI) by estimating: (1) the innovation headroom and (2) the potential cost effectiveness of roflumilast treatment in this population.

METHODS: The innovation headroom was operationalized by a fictive 100% efficacious treatment effect, and the roflumilast effect on memory word learning test was assumed to be associated with 7% relative risk reduction of dementia onset. Both were compared to Dutch setting usual care using the adapted International Pharmaco-Economic Collaboration on Alzheimer's Disease (IPECAD) open-source model.

RESULTS: The total innovation headroom expressed as net health benefit was 4.2 (95% bootstrap interval: 2.9-5.7) quality-adjusted life years (QALYs). The potential cost effectiveness of roflumilast was k€34 per QALY.

DISCUSSION: The innovation headroom in MCI is substantial. Although the potential cost effectiveness of roflumilast treatment is uncertain, further research on its effect on dementia onset is likely valuable.

Original language	English
Pages (from-to)	3458-3471
Number of pages	14
Journal	Alzheimer's & Dementia
Volume	19
Issue number	8
Early online date	18 Feb 2023
DOIs	https://doi.org/10.1002/alz.13001
Publication status	Published - Aug 2023

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10.1002/alz.13001Licence: CC BY-NC

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Handels, R., Grimm, S., Blokland, A., Possemis, N., Ramakers, I., Sambeth, A., Verhey, F., Vos, S., Joore, M., Prickaerts, J., & Jönsson, L. (2023). The value of maintaining cognition in patients with mild cognitive impairment: The innovation headroom and potential cost-effectiveness of roflumilast. Alzheimer's & Dementia, 19(8), 3458-3471. https://doi.org/10.1002/alz.13001

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title = "The value of maintaining cognition in patients with mild cognitive impairment: The innovation headroom and potential cost-effectiveness of roflumilast",

abstract = "INTRODUCTION: Early health-technology assessment can support discussing scarce resource allocation among stakeholders. We explored the value of maintaining cognition in patients with mild cognitive impairment (MCI) by estimating: (1) the innovation headroom and (2) the potential cost effectiveness of roflumilast treatment in this population.METHODS: The innovation headroom was operationalized by a fictive 100% efficacious treatment effect, and the roflumilast effect on memory word learning test was assumed to be associated with 7% relative risk reduction of dementia onset. Both were compared to Dutch setting usual care using the adapted International Pharmaco-Economic Collaboration on Alzheimer's Disease (IPECAD) open-source model.RESULTS: The total innovation headroom expressed as net health benefit was 4.2 (95% bootstrap interval: 2.9-5.7) quality-adjusted life years (QALYs). The potential cost effectiveness of roflumilast was k€34 per QALY.DISCUSSION: The innovation headroom in MCI is substantial. Although the potential cost effectiveness of roflumilast treatment is uncertain, further research on its effect on dementia onset is likely valuable.",

author = "Ron Handels and Sabine Grimm and Arjan Blokland and Nina Possemis and Inez Ramakers and Anke Sambeth and Frans Verhey and Stephanie Vos and Manuela Joore and Jos Prickaerts and Linus J{\"o}nsson",

note = "{\textcopyright} 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2023",

month = aug,

doi = "10.1002/alz.13001",

language = "English",

volume = "19",

pages = "3458--3471",

journal = "Alzheimer's & Dementia",

issn = "1552-5260",

publisher = "Elsevier Science",

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Handels, R , Grimm, S , Blokland, A , Possemis, N , Ramakers, I , Sambeth, A , Verhey, F , Vos, S , Joore, M, Prickaerts, J & Jönsson, L 2023, 'The value of maintaining cognition in patients with mild cognitive impairment: The innovation headroom and potential cost-effectiveness of roflumilast', Alzheimer's & Dementia, vol. 19, no. 8, pp. 3458-3471. https://doi.org/10.1002/alz.13001

TY - JOUR

T1 - The value of maintaining cognition in patients with mild cognitive impairment

T2 - The innovation headroom and potential cost-effectiveness of roflumilast

AU - Handels, Ron

AU - Grimm, Sabine

AU - Blokland, Arjan

AU - Possemis, Nina

AU - Ramakers, Inez

AU - Sambeth, Anke

AU - Verhey, Frans

AU - Vos, Stephanie

AU - Joore, Manuela

AU - Prickaerts, Jos

AU - Jönsson, Linus

PY - 2023/8

Y1 - 2023/8

N2 - INTRODUCTION: Early health-technology assessment can support discussing scarce resource allocation among stakeholders. We explored the value of maintaining cognition in patients with mild cognitive impairment (MCI) by estimating: (1) the innovation headroom and (2) the potential cost effectiveness of roflumilast treatment in this population.METHODS: The innovation headroom was operationalized by a fictive 100% efficacious treatment effect, and the roflumilast effect on memory word learning test was assumed to be associated with 7% relative risk reduction of dementia onset. Both were compared to Dutch setting usual care using the adapted International Pharmaco-Economic Collaboration on Alzheimer's Disease (IPECAD) open-source model.RESULTS: The total innovation headroom expressed as net health benefit was 4.2 (95% bootstrap interval: 2.9-5.7) quality-adjusted life years (QALYs). The potential cost effectiveness of roflumilast was k€34 per QALY.DISCUSSION: The innovation headroom in MCI is substantial. Although the potential cost effectiveness of roflumilast treatment is uncertain, further research on its effect on dementia onset is likely valuable.

AB - INTRODUCTION: Early health-technology assessment can support discussing scarce resource allocation among stakeholders. We explored the value of maintaining cognition in patients with mild cognitive impairment (MCI) by estimating: (1) the innovation headroom and (2) the potential cost effectiveness of roflumilast treatment in this population.METHODS: The innovation headroom was operationalized by a fictive 100% efficacious treatment effect, and the roflumilast effect on memory word learning test was assumed to be associated with 7% relative risk reduction of dementia onset. Both were compared to Dutch setting usual care using the adapted International Pharmaco-Economic Collaboration on Alzheimer's Disease (IPECAD) open-source model.RESULTS: The total innovation headroom expressed as net health benefit was 4.2 (95% bootstrap interval: 2.9-5.7) quality-adjusted life years (QALYs). The potential cost effectiveness of roflumilast was k€34 per QALY.DISCUSSION: The innovation headroom in MCI is substantial. Although the potential cost effectiveness of roflumilast treatment is uncertain, further research on its effect on dementia onset is likely valuable.

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DO - 10.1002/alz.13001

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