Jakub Hlávka, Masaryk University: Valuing Dementia Interventions Under Uncertainty A Comparison of GRACE and Traditional Cost-Effectiveness

Title:   Valuing Dementia Interventions Under Uncertainty A Comparison of GRACE and Traditional Cost-Effectiveness

Abstract: Traditional cost-effectiveness analysis (TCEA) assumes patients are risk-neutral over health, potentially misvaluing treatments for severe diseases. Generalized and risk-adjusted cost-effectiveness (GRACE) relaxes this assumption, but its implications for neurodegenerative diseases are unexplored. Using a five-state Markov model of a hypothetical dementia therapy for U.S. patients aged 70, we find that GRACE increases risk-adjusted health gains more than four-fold (2.15 vs. 0.49 QALYs) but simultaneously reduces the cost-effectiveness threshold by 76%, because high mortality prevents most patients from reaching the severest health states. These effects largely offset, yielding only a 3% increase in net monetary benefit. Although bottom-line valuations converge, GRACE offers a more transparent decomposition of treatment value that may better inform coverage decisions for expensive disease-modifying therapies.

Presenter: Jakub Hlávka, Masaryk University

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