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

Abstract

AbstractINTRODUCTIONEarly 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.METHODSThe 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.RESULTSThe 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.DISCUSSIONThe 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.