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Genetic interventions, such as RNA-based therapies, are being developed but those currently available are very expensive. Early evaluation of costs and benefits is, therefore, crucial. By developing a health economic model, we aimed to provide first insights into the potential cost-effectiveness of RNA-based therapies for SCA1 in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We simulated disease progression of individuals with SCA1 using a patient-level state-transition model. Five hypothetical treatment strategies with different start and endpoints and level of effectiveness (5\u201350% reduction in disease progression) were evaluated. Consequences of each strategy were measured in terms of quality-adjusted life years (QALYs), survival, healthcare costs, and maximum costs to be cost effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most QALYs (6.68) are gained when therapy starts during the pre-ataxic stage and continues during the entire disease course. Incremental costs are lowest (\u2212\u2009\u20ac14,048) if therapy is stopped when the severe ataxia stage is reached. The maximum costs per year to be cost-effective are \u20ac19,630 in the \u201cstop after moderate ataxia stage\u201d strategy at 50% effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our model indicates that the maximum price for a hypothetical therapy to be cost-effective is considerably lower than currently available RNA-based therapies. Most value for money can be gained by slowing progression in the early and moderate stages of SCA1 and by stopping therapy upon entering the severe ataxia stage. To allow for such a strategy, it is crucial to identify individuals in early stages of disease, preferably just before symptom onset.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00415-023-11704-3","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T16:02:32Z","timestamp":1681920152000},"page":"3788-3798","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The potential value of disease-modifying therapy in patients with spinocerebellar ataxia type 1: an early health economic modeling study"],"prefix":"10.1007","volume":"270","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-0801","authenticated-orcid":false,"given":"Teije","family":"van Prooije","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3657-5773","authenticated-orcid":false,"given":"Sanne","family":"Ruigrok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1873-7559","authenticated-orcid":false,"given":"Niels","family":"van den Berkmortel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-1287","authenticated-orcid":false,"given":"Roderick P. 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The SCA3 medical consumption data were obtained through a study approved by the ethics committee of Radboud university medical center (NL65454.091.18). Informed consent from all these participants was obtained. All other information was derived from publicly available sources.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and informed consent"}}]}}