INTRODUCTION: Countries have varying, limited healthcare budgets for emerging disease-modifying therapies. Cost-effectiveness analysis, combined with country-level cost-effectiveness thresholds, can be used to estimate value-based prices (VBPs) for lecanemab and donanemab across 174 countries. METHODS: The cost-effectiveness of lecanemab and donanemab was estimated using incremental cost and quality-adjusted life years (QALYs) compared to usual care. Published cost-effectiveness thresholds were used to estimate VBPs of these drugs across 174 countries. RESULTS: Compared to usual care, lecanemab and donanemab respectively increased average QALYs by 0. 38 and 0. 51. By country income status, VBPs for lecanemab and donanemab respectively ranged between 254 to 9434 and 387 to 13, 964 (high income), 90 to 1025 and 137 to 1507 (upper middle income), 11 to 623 and 21 to 956 (lower middle income) and 4 to 18 and 9 to 32 (low income). DISCUSSION: VBPs indicate how much 174 countries should be willing to pay. This framework can also be adapted and refined in the negotiation of country pricing.
Hoang et al. (Fri,) studied this question.