Addressing Challenges to Alternative Payment Models for New Alzheimer’s Disease Therapies for US Commercial Payers

Commercial payers that ultimately decide to cover aducanumab or other Alzheimer’s disease therapies may require innovative payment tools to minimize their financial risk given the uncertain benefits and high cost of such treatments. Drawing on the published evidence, we propose two different types o...

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Bibliographic Details
Published in:PharmacoEconomics 2022-07, Vol.40 (7), p.647-652
Main Authors: Hlávka, Jakub P., Lavelle, Tara A., Neumann, Peter J., Lin, Pei-Jung
Format: Article
Language:English
Subjects:
Alzheimer Disease - drug therapy
Alzheimer's disease
Bias
Clinical outcomes
Clinical trials
Cognitive ability
Costs
Current Opinion
Drug therapy
FDA approval
Health Administration
Health Economics
Humans
Infrastructure
Installment payments
Management
Medicaid
Medicare
Medicine
Medicine & Public Health
Patients
Pharmacoeconomics and Health Outcomes
Prospective payment systems (Medical care)
Public Health
Quality of Life Research
Social aspects
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Summary:Commercial payers that ultimately decide to cover aducanumab or other Alzheimer’s disease therapies may require innovative payment tools to minimize their financial risk given the uncertain benefits and high cost of such treatments. Drawing on the published evidence, we propose two different types of payment models applicable to disease-modifying therapies in Alzheimer’s disease, and suggest four strategies to overcome challenges in their implementation. Such strategies range from developing best practices for outcome measurement in Alzheimer’s disease, investing in infrastructure to collect real-world data, increasing representativeness of registry data in Alzheimer’s disease, and integrating the diagnostic, treatment, and payment landscape. These important steps could make access to emerging therapies in Alzheimer’s disease more sustainable in the long term, and could serve as a blueprint for better access to novel therapies in other indications in the future.
ISSN:1170-7690
1179-2027
DOI:10.1007/s40273-022-01150-w