{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:19:05Z","timestamp":1788261545995,"version":"build-2803163510"},"reference-count":70,"publisher":"Walter de Gruyter GmbH","issue":"1","funder":[{"name":"Genentech, a member of Roche Group"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Traditional cost-effectiveness analysis (TCEA) overlooks nonlinear patient health preferences, potentially under-valuing health gains for severe diseases and overvaluing health gains for less severe diseases. Generalized and risk-adjusted cost effectiveness (GRACE) can address this limitation by incorporating patient risk preferences and disease severity, but its implication for valuing treatments for neurodegenerative diseases is unclear. A five-state Markov model was developed to estimate the health economic value of a hypothetical treatment which delayed dementia onset by 30\u202f% versus the standard of care (SoC) for 70-year-old patients diagnosed with mild cognitive impairment. GRACE was implemented using relative risk aversion (RRA) estimates from a U.S. general population survey. Treatment value was measured as risk-and severity adjusted net monetary benefit (RASA-NMB). Risk-neutral TCEA results were computed for comparison. Under TCEA, the hypothetical treatment improved health outcomes by 0.49 quality-adjusted life-years (QALYs) (3.72 vs 3.23 QALYs). Using GRACE, Generalized and Risk-Adjusted QALYs (GRA-QALY) were 3.69 times larger under GRACE than TCEA (2.15 \u0394GRA-QALY; 4.91 GRA-QALYs vs 2.76 GRA-QALYs), reflecting additional utility from reduced variance in the distribution of future health and a higher value placed on additional survival relative to health improvement. However, willingness to pay for these gains was 76.4\u202f% lower under GRACE due to high mortality before patients progressed to severe health states ($23,622 per GRA-QALY vs $100,000 per QALY). On net, GRACE increased the net monetary benefit by 3\u202f% compared to TCEA (RASA-NMB\u00a0=\u00a0$51,430 vs TCEA NMB\u00a0=\u00a0$49,914). In summary, despite large increases in patient utility gains, GRACE had a modest impact on treatment value for neurological conditions causing cognitive impairments.<\/jats:p>","DOI":"10.1515\/fhep-2025-0034","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T01:55:48Z","timestamp":1787277348000},"page":"1-31","source":"Crossref","is-referenced-by-count":0,"title":["Valuing Dementia Interventions Under Uncertainty: A Comparison of Generalized and Risk-Adjusted Cost Effectiveness to Traditional Cost-Effectiveness Analyses"],"prefix":"10.1515","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8444-5979","authenticated-orcid":false,"given":"Jason","family":"Shafrin","sequence":"first","affiliation":[{"name":"FTI Consulting , 350 S. Grand Ave. Suite 3000 , Los Angeles , CA 90071 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehong","family":"Kim","sequence":"additional","affiliation":[{"name":"FTI Consulting , 350 S. Grand Ave. Suite 3000 , Los Angeles , CA 90071 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Fajnor","sequence":"additional","affiliation":[{"name":"FTI Consulting , 350 S. Grand Ave. Suite 3000 , Los Angeles , CA 90071 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyi-Sin","family":"Than","sequence":"additional","affiliation":[{"name":"FTI Consulting , 555 12th St. NW STE 700 , Washington , DC 20004 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S.","family":"Mearns","sequence":"additional","affiliation":[{"name":"Genentech , 1 DNA Way , South San Francisco , CA 94080 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey L.","family":"Kowal","sequence":"additional","affiliation":[{"name":"Genentech , 1 DNA Way , South San Francisco , CA 94080 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Majda","sequence":"additional","affiliation":[{"name":"Genentech , 1 DNA Way , South San Francisco , CA 94080 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub P.","family":"Hl\u00e1vka","sequence":"additional","affiliation":[{"name":"University of Southern California , 635 Downey Way , Los Angeles , CA 90089 , USA"},{"name":"Health Economics, Policy, and Innovation Institute , Masaryk University , Lipov\u00e1 41a , Brno , 602 00 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2026090110555966580_j_fhep-2025-0034_ref_002","unstructured":"Administration, Food and Drug. 2023a. \u201cLEQEMBI (Lencanemab-irmb) Injection, for Intravenous Use.\u201d Food and Drug Administration. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2023\/761269s000lbl.pdf."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_004","unstructured":"Administration on Ageing. 2020. Costs of Care. https:\/\/acl.gov\/ltc\/costs-and-who-pays\/costs-of-care."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_005","doi-asserted-by":"crossref","unstructured":"Alam, John J., Paul Maruff, Susan R. Doctrow, Hui-May Chu, Jennifer Conway, Stephen N. Gomperts, et al.. 2023. \u201cAssociation of Plasma Phosphorylated Tau with the Response to Neflamapimod Treatment in Patients with Dementia with Lewy Bodies.\u201d Neurology 101 (17): e1708\u2013e1717. https:\/\/doi.org\/10.1212\/wnl.0000000000207755.","DOI":"10.1212\/WNL.0000000000207755"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_006","doi-asserted-by":"crossref","unstructured":"Andersen, Kjeld, Annette Lolk, Torben Martinussen, and Per Kragh-S\u00f8rensen. 2010. \u201cVery Mild to Severe Dementia and Mortality: A 14-Year Follow-Up\u2013The Odense Study.\u201d Dementia and Geriatric Cognitive Disorders 29 (1): 61\u20137. https:\/\/doi.org\/10.1159\/000265553.","DOI":"10.1159\/000265553"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_007","doi-asserted-by":"crossref","unstructured":"Basu, Anirban, Josh Carlson, and David Veenstra. 2020. \u201cHealth Years in Total: A New Health Objective Function for Cost-Effectiveness Analysis.\u201d Value in Health 23 (1): 96\u2013103. https:\/\/doi.org\/10.1016\/j.jval.2019.10.014.","DOI":"10.1016\/j.jval.2019.10.014"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_008","doi-asserted-by":"crossref","unstructured":"Berg, Leonard. 1984. \u201cClinical Dementia Rating.\u201d The British Journal of Psychiatry 145 (3): 339. https:\/\/doi.org\/10.1192\/s0007125000118082.","DOI":"10.1192\/S0007125000118082"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_009","doi-asserted-by":"crossref","unstructured":"Boustani, Malaz, Erin G. Doty, Louis P. GarrisonJr, Lee J. Smolen, Mark Belger, Timothy M. Klein, et al.. 2022. \u201cAssessing the Cost-Effectiveness of a Hypothetical Disease-Modifying Therapy with Limited Duration for the Treatment of Early Symptomatic Alzheimer Disease.\u201d Clinical Therapeutics 44 (11): 1449\u201362. https:\/\/doi.org\/10.1016\/j.clinthera.2022.09.008.","DOI":"10.1016\/j.clinthera.2022.09.008"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_010","doi-asserted-by":"crossref","unstructured":"Brockmann, R., J. Nixon, B. L. Love, and I. Yunusa. 2023. \u201cImpacts of FDA Approval and Medicare Restriction on Antiamyloid Therapies for Alzheimer\u2019s Disease: Patient Outcomes, Healthcare Costs, and Drug Development.\u201d The Lancet Regional Health. Americas 20: 100467. https:\/\/doi.org\/10.1016\/j.lana.2023.100467.","DOI":"10.1016\/j.lana.2023.100467"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_011","unstructured":"Centers for Medicare and Medicaid Services. 2022. \u201cCMS Finalizes Medicare Coverage Policy for Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer\u2019s Disease.\u201d https:\/\/www.cms.gov\/newsroom\/press-releases\/cms-finalizes-medicare-coverage-policy-monoclonal-antibodies-directed-against-amyloid-treatment#:\u223c:text=CMS%20followed%20a%20long%2Dstanding,for%20people%20with%20Alzheimer\u2019s%20disease (accessed October 29, 2024)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_012","unstructured":"CMS. 2023. \u201cPhysician Fee Schedule.\u201d https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search?Y=0&T=4&HT=0&CT=3&H1=70553&M=5 (accessed April 7, 2023)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_013","doi-asserted-by":"crossref","unstructured":"Cohen, Joshua T. 2024. \u201cIt Is Time to Reconsider the 3% Discount Rate.\u201d Value in Health 27 (5): 578\u201384. https:\/\/doi.org\/10.1016\/j.jval.2024.03.001.","DOI":"10.1016\/j.jval.2024.03.001"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_014","doi-asserted-by":"crossref","unstructured":"Cummings, Jeffrey. 2023. \u201cAnti-Amyloid Monoclonal Antibodies are Transformative Treatments that Redefine Alzheimer\u2019s Disease Therapeutics.\u201d Drugs 83 (7): 569\u201376. https:\/\/doi.org\/10.1007\/s40265-023-01858-9.","DOI":"10.1007\/s40265-023-01858-9"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_015","doi-asserted-by":"crossref","unstructured":"Drupp, Moritz A., Mark C. Freeman, Ben Groom, and Frikk Nesje. 2018. \u201cDiscounting Disentangled.\u201d American Economic Journal: Economic Policy 10 (4): 109\u201334. https:\/\/doi.org\/10.1257\/pol.20160240.","DOI":"10.1257\/pol.20160240"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_016","doi-asserted-by":"crossref","unstructured":"Dyer, Owen. 2024. \u201cAduhelm: Biogen Abandons Alzheimer\u2019s Drug After Controversial Approval Left it Unfunded by Medicare.\u201d BMJ British Medical Journal 384: q281. https:\/\/doi.org\/10.1136\/bmj.q281.","DOI":"10.1136\/bmj.q281"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_017","doi-asserted-by":"crossref","unstructured":"Ekman, Mattias, Jenny Berg, Anders Wimo, Linus J\u00f6nsson, and Christopher McBurney. 2007. \u201cHealth Utilities in Mild Cognitive Impairment and Dementia: A Population Study in Sweden.\u201d International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences 22 (7): 649\u201355. https:\/\/doi.org\/10.1002\/gps.1725.","DOI":"10.1002\/gps.1725"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_018","doi-asserted-by":"crossref","unstructured":"Esposito, Lucio, and Nicole Hassoun. 2017. \u201cMeasuring Health Burden Without Discriminating Against the Disabled.\u201d Journal of Public Health 39 (3): 633\u20139.","DOI":"10.1093\/pubmed\/fdw072"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_019","doi-asserted-by":"crossref","unstructured":"Filippi, Massimo, Giordano Cecchetti, Edoardo Gioele Spinelli, Paolo Vezzulli, Andrea Falini, and Federica Agosta. 2022. \u201cAmyloid-Related Imaging Abnormalities and \u03b2-Amyloid\u2013Targeting Antibodies: A Systematic Review.\u201d JAMA Neurology 79 (3): 291\u2013304.","DOI":"10.1001\/jamaneurol.2021.5205"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_020","doi-asserted-by":"crossref","unstructured":"Fleck, Leonard M. 2021. \u201cAlzheimer\u2019s and Aducanumab: Unjust Profits and False Hopes.\u201d Hastings Center Report 51 (4): 9\u201311. https:\/\/doi.org\/10.1002\/hast.1264.","DOI":"10.1002\/hast.1264"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_021","unstructured":"Food and Drug Administration. 2023. \u201cLeqembi\u00a0\u2013 Lecanemab Injection, Solution.\u201d"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_022","unstructured":"Food and Drug Administration. 2024. \u201cFDA Approves Treatment for Adults with Alzheimer\u2019s Disease.\u201d https:\/\/www.fda.gov\/drugs\/news-events-human-drugs\/fda-approves-treatment-adults-alzheimers-disease#:\u223c:text=The%20U.S.%20Food%20and%20Drug,studied%20in%20the%20clinical%20trials."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_023","doi-asserted-by":"crossref","unstructured":"Gitlin, Laura N., Helen C. Kales, and Constantine G. Lyketsos. 2012. \u201cNonpharmacologic Management of Behavioral Symptoms in Dementia.\u201d JAMA 308 (19): 2020\u20139. https:\/\/doi.org\/10.1001\/jama.2012.36918.","DOI":"10.1001\/jama.2012.36918"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_024","doi-asserted-by":"crossref","unstructured":"Graf, Marlon, Joris Kleintjens, Md Tahsin Hasan, Natalie Land, Jacquelyn W. Chou, and Karen Mulligan. 2025. \u201cImplementing the Generalized Risk-Adjusted Cost-Effectiveness Model for Sickle Cell Disease: A Case Study.\u201d Value in Health 28 (8): 1153\u201360. https:\/\/doi.org\/10.1016\/j.jval.2025.05.005.","DOI":"10.1016\/j.jval.2025.05.005"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_025","doi-asserted-by":"crossref","unstructured":"Grosse, Scott D., Kurt V. Krueger, and Jamison Pike. 2019. \u201cEstimated Annual and Lifetime Labor Productivity in the United States, 2016: Implications for Economic Evaluations.\u201d Journal of Medical Economics 22 (6): 501\u20138. https:\/\/doi.org\/10.1080\/13696998.2018.1542520.","DOI":"10.1080\/13696998.2018.1542520"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_026","doi-asserted-by":"crossref","unstructured":"Haro, J.\u00a0M., and Kristin Kahle-Wrobleski. 2014. \u201cAnalysis of Burden in Caregivers of People with Alzheimer\u2019s Disease Using Self-Report and Supervision Hours.\u201d The Journal of Nutrition, Health & Aging 18 (7): 677\u201384, https:\/\/doi.org\/10.1007\/s12603-014-0500-x.","DOI":"10.1007\/s12603-014-0500-x"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_027","doi-asserted-by":"crossref","unstructured":"He\u00dfmann, Philipp, Greta Seeberg, Jens Peter Reese, Judith Dams, Erika Baum, Matthias J. M\u00fcller, et al.. 2016. \u201cHealth-Related Quality of Life in Patients with Alzheimer\u2019s Disease in Different German Health Care Settings.\u201d Journal of Alzheimer\u2019s Disease 51 (2): 545\u201361.","DOI":"10.3233\/JAD-150835"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_029","unstructured":"Institute for Clinical and Economic Review. 2019. Siponimod for the Treatment of Secondary Progressive Multiple Sclerosis: Effectiveness and Value."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_030","unstructured":"Institute for Clinical and Economic Review. 2023a. \u201cLecanemab for Early Alzheimer\u2019s Disease.\u201d https:\/\/icer.org\/assessment\/alzheimers-disease-2022\/."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_031","unstructured":"Institute for Clinical and Economic Review. 2023b. Value Assessment Framework. Cambdridge: Institute for Clinical and Economic Review."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_032","unstructured":"Institute for Clinical and Economic Review. 2023c. \u201cValue Assessment Framework.\u201d https:\/\/icer.org\/wp-content\/uploads\/2023\/09\/ICER_2023_VAF_For-Publication_092523.pdf."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_033","doi-asserted-by":"crossref","unstructured":"Jakab, I., M. D. Whittington, E. Franklin, S. Raiola, J.\u00a0D. Campbell, Z. Kal\u00f3, et al.. 2021. \u201cPatient and Payer Preferences for Additional Value Criteria.\u201d Frontiers in Pharmacology 12: 690021. https:\/\/doi.org\/10.3389\/fphar.2021.690021.","DOI":"10.3389\/fphar.2021.690021"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_034","doi-asserted-by":"crossref","unstructured":"Jiao, Boshen, and Anirban Basu. 2023. \u201cAssociating Health-Related Quality-of-Life Score with Time Uses to Inform Productivity Measures in Cost-Effectiveness Analysis.\u201d Pharmacoeconomics 41 (9): 1065\u201377. https:\/\/doi.org\/10.1007\/s40273-023-01246-x.","DOI":"10.1007\/s40273-023-01246-x"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_035","unstructured":"Johnson, Richard W. 2019. What is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports. Washington: Office of the Assistant Secretary for Planning and Evaluation."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_037","doi-asserted-by":"crossref","unstructured":"Lakdawalla, Darius N., Jalpa A. Doshi, Louis P. GarrisonJr, E. Phelps Charles, Anirban Basu, and Patricia M. Danzon. 2018. \u201cDefining Elements of Value in Health Care\u00a0\u2013 A Health Economics Approach: An ISPOR Special Task Force Report [3].\u201d Value in Health 21 (2): 131\u20139. https:\/\/doi.org\/10.1016\/j.jval.2017.12.007.","DOI":"10.1016\/j.jval.2017.12.007"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_038","doi-asserted-by":"crossref","unstructured":"Lakdawalla, Darius N., and Charles E. Phelps. 2020. \u201cHealth Technology Assessment with Risk Aversion in Health.\u201d Journal of Health Economics 72 (1): 102346, https:\/\/doi.org\/10.1016\/j.jhealeco.2020.102346.","DOI":"10.1016\/j.jhealeco.2020.102346"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_039","doi-asserted-by":"crossref","unstructured":"Lakdawalla, Darius N., and Charles E. Phelps. 2021. \u201cHealth Technology Assessment with Diminishing Returns to Health: The Generalized Risk-Adjusted Cost-Effectiveness (GRACE) Approach.\u201d Value in Health 24 (2): 244\u20139. https:\/\/doi.org\/10.1016\/j.jval.2020.10.003.","DOI":"10.1016\/j.jval.2020.10.003"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_040","doi-asserted-by":"crossref","unstructured":"Lakdawalla, Darius N., and Charles E. Phelps. 2022. \u201cA Guide to Extending and Implementing Generalized Risk-Adjusted Cost-Effectiveness (GRACE).\u201d The European Journal of Health Economics 23 (3): 433\u201351. https:\/\/doi.org\/10.1007\/s10198-021-01367-0.","DOI":"10.1007\/s10198-021-01367-0"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_041","doi-asserted-by":"crossref","unstructured":"Landeiro, Filipa, Seher Mughal, Katie Walsh, Elsbeth Nye, Jasmine Morton, Harriet Williams, et al.. 2020. \u201cHealth-Related Quality of Life in People with Predementia Alzheimer\u2019s Disease, Mild Cognitive Impairment or Dementia Measured with Preference-Based Instruments: A Systematic Literature Review.\u201d Alzheimer\u2019s Research & Therapy 12 (1): 1\u201314. https:\/\/doi.org\/10.1186\/s13195-020-00723-1.","DOI":"10.1186\/s13195-020-00723-1"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_043","doi-asserted-by":"crossref","unstructured":"Leibson, Cynthia L., Kirsten Hall Long, Jeanine E. Ransom, Rosebud O. Roberts, Steven L. Hass, Amy M. Duhig, et al.. 2015. \u201cDirect Medical Costs and Source of Cost Differences Across the Spectrum of Cognitive Decline: A Population-Based Study.\u201d Alzheimer\u2019s & Dementia 11 (8): 917\u201332. https:\/\/doi.org\/10.1016\/j.jalz.2015.01.007.","DOI":"10.1016\/j.jalz.2015.01.007"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_044","doi-asserted-by":"crossref","unstructured":"Lin, Pei-Jung, Abigail G. Riley, Patricia G. Synnott, Terry L. Frangiosa, Amber Roniger, Peter J. Neumann, et al.. 2025. \u201cHealth Utilities in Alzheimer\u2019s Disease: A Survey of Patients and Caregivers in the United States.\u201d Journal of Alzheimer\u2019s Disease 106 (3): 943\u201353. https:\/\/doi.org\/10.1177\/13872877251350381.","DOI":"10.1177\/13872877251350381"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_045","unstructured":"Lin, Grace, Melanie Whittingtong, Patricia Synnott, Avery McKenna, John Campbell, Steven Pearson, et al.. 2021. Aducanumab for Alzheimer\u2019s Disease: Effectiveness and Value. Institute for Clinical and Economic Review (California Technology Assessment Forum)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_047","doi-asserted-by":"crossref","unstructured":"Mesterton, J., A. Wimo, S. Langworth, B. Winblad, and L. Jonsson. 2010. \u201cCross Sectional Observational Study on the Societal Costs of Alzheimer\u2019s Disease.\u201d Current Alzheimer Research 7 (4): 358\u201367. https:\/\/doi.org\/10.2174\/156720510791162430.","DOI":"10.2174\/156720510791162430"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_048","doi-asserted-by":"crossref","unstructured":"Mintun, Mark A., Albert C. Lo, Cynthia Duggan Evans, Alette M. Wessels, Paul A. Ardayfio, Scott W. Andersen, et al.. 2021. \u201cDonanemab in Early Alzheimer\u2019s Disease.\u201d New England Journal of Medicine 384 (18): 1691\u2013704. https:\/\/doi.org\/10.1056\/nejmoa2100708.","DOI":"10.1056\/NEJMoa2100708"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_049","doi-asserted-by":"crossref","unstructured":"Monfared, Tahami, Amir Abbas, Michael J. Byrnes, Leigh Ann White, and Quanwu Zhang. 2022. \u201cAlzheimer\u2019s Disease: Epidemiology and Clinical Progression.\u201d Neurology and Therapy 11 (2): 553\u201369.","DOI":"10.1007\/s40120-022-00338-8"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_051","doi-asserted-by":"crossref","unstructured":"Mudumba, Rahul, William V. Padula, and Darius Lakdawalla. 2025. \u201cEE192 A Simple and Practical Guide to Implementing Generalized Risk-Adjusted Cost-Effectiveness (GRACE): A Case Study in Non-Small Cell Lung Cancer.\u201d Value in Health 28 (6): S98. https:\/\/doi.org\/10.1016\/j.jval.2025.04.483.","DOI":"10.1016\/j.jval.2025.04.483"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_052","doi-asserted-by":"crossref","unstructured":"Mulligan, Karen, Drishti Baid, Jason N. Doctor, Charles E. Phelps, and Darius N. Lakdawalla. 2024. \u201cRisk Preferences over Health: Empirical Estimates and Implications for Medical Decision-Making.\u201d Journal of Health Economics 94 (1): 102857, https:\/\/doi.org\/10.1016\/j.jhealeco.2024.102857.","DOI":"10.1016\/j.jhealeco.2024.102857"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_053","doi-asserted-by":"crossref","unstructured":"Naglie, G., D. B. Hogan, M. Krahn, B. L. Beattie, S. E. Black, C. Macknight, et al.. 2011. \u201cPredictors of Patient Self-Ratings of Quality of Life in Alzheimer Disease: Cross-Sectional Results From the Canadian Alzheimer\u2019s Disease Quality of Life Study.\u201d American Journal of Geriatric Psychiatry 19 (10): 881\u201390. https:\/\/doi.org\/10.1097\/JGP.0b013e3182006a67.","DOI":"10.1097\/JGP.0b013e3182006a67"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_055","doi-asserted-by":"crossref","unstructured":"Neumann, P. J., and D. D. Kim. 2023. \u201cCost-Effectiveness Thresholds Used by Study Authors, 1990\u20132021.\u201d JAMA 329 (15): 1312\u20134. https:\/\/doi.org\/10.1001\/jama.2023.1792.","DOI":"10.1001\/jama.2023.1792"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_056","doi-asserted-by":"crossref","unstructured":"Neumann, Peter J., Karen M. Kuntz, Joel Leon, Sally S. Araki, Richard C. Hermann, and Ming-Ann Hsu, et al.. 1999. \u201cHealth Utilities in Alzheimer\u2019s Disease: A Cross-Sectional Study of Patients and Caregivers.\u201d Medical Care 37 (1): 27\u201332, https:\/\/doi.org\/10.1097\/00005650-199901000-00005.","DOI":"10.1097\/00005650-199901000-00005"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_057","doi-asserted-by":"crossref","unstructured":"Nichols, Emma, Jaimie D. Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, et al.. 2022. \u201cEstimation of the Global Prevalence of Dementia in 2019 and Forecasted Prevalence in 2050: An Analysis for the Global Burden of Disease Study 2019.\u201d The Lancet Public Health 7 (2): e105\u2013e125. https:\/\/doi.org\/10.1016\/s2468-2667(21)00249-8.","DOI":"10.1002\/alz.051496"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_058","doi-asserted-by":"crossref","unstructured":"Nielsen, Jytte Seested, Dorte Gyrd\u2010Hansen, and Trine Kj\u00e6r. 2021. \u201cSample Restrictions and the Elicitation of a Constant Willingness to Pay Per Quality Adjusted Life Year.\u201d Health Economics 30 (5): 923\u201331. https:\/\/doi.org\/10.1002\/hec.4236.","DOI":"10.1002\/hec.4236"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_059","doi-asserted-by":"crossref","unstructured":"Ortega, L., D. Incerti, K. Bean, C. Fields, F. Pang, and D. 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Tan, Tahmineh Romero, Neil S. Wenger, Emmett Keeler, and Lee A. Jennings. 2019. \u201cPatient and Caregiver Benefit From a Comprehensive Dementia Care Program: 1\u2010Year Results From the UCLA Alzheimer\u2019s and Dementia Care Program.\u201d Journal of the American Geriatrics Society 67 (11): 2267\u201373. https:\/\/doi.org\/10.1111\/jgs.16085.","DOI":"10.1111\/jgs.16085"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_063","doi-asserted-by":"crossref","unstructured":"Robinson, Rebecca L., Dorene M. Rentz, Jeffrey Scott Andrews, Anthony Zagar, Yongin Kim, Valerie Bruemmer, et al.. 2020. \u201cCosts of Early Stage Alzheimer\u2019s Disease in the United States: Cross-Sectional Analysis of a Prospective Cohort Study (GERAS-US).\u201d Journal of Alzheimer\u2019s Disease 75 (2): 437\u201350. https:\/\/doi.org\/10.3233\/jad-191212.","DOI":"10.3233\/JAD-191212"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_065","doi-asserted-by":"crossref","unstructured":"Sanders, Gillian D., Peter J. Neumann, Anirban Basu, Dan W. Brock, David Feeny, Krahn Murray, et al.. 2016. \u201cRecommendations for Conduct, Methodological Practices, and Reporting of Cost-Effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine.\u201d JAMA 316 (10): 1093\u2013103. https:\/\/doi.org\/10.1001\/jama.2016.12195.","DOI":"10.1001\/jama.2016.12195"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_066","doi-asserted-by":"crossref","unstructured":"Shafrin, Jason, Jaehong Kim, Joshua T. Cohen, Louis P. Garrison, Dana A. Goldman, Jalpa A. Doshi, et al.. 2024a. \u201cValuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices.\u201d Forum for Health Economics & Policy 27 (1): 29\u2013116.","DOI":"10.1515\/fhep-2024-0014"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_067","doi-asserted-by":"crossref","unstructured":"Shafrin, Jason, Kyi\u2010Sin Than, Jaehong Kim, Fajnor Jacob, Elizabeth S. Mearns, Stacey L. Kowal, et al.. 2024b. \u201cAssessing Treatment Value Under Uncertainty: Measuring Treatment Value for a New Treatment for Cognitive Impairment.\u201d Alzheimer\u2019s & Dementia 20 (S7): e089925. https:\/\/doi.org\/10.1002\/alz.089925.","DOI":"10.1002\/alz.089925"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_068","doi-asserted-by":"crossref","unstructured":"Shafrin, Jason, Jaehong Kim, Fajnor Jacob, Than Kyi-Sin, S. Mearns Elizabeth, L. Kowal Stacey, et al.. 2025a. \u201cA Generalized Risk Adjusted Cost Effectiveness (GRACE) Economic Model for Measuring the Value of Interventions that Delay Mobility Impairment Across Neurological Conditions.\u201d Value in Health 29 (1): 46-53.","DOI":"10.1016\/j.jval.2025.08.006"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_069","doi-asserted-by":"crossref","unstructured":"Shafrin, Jason, Kyi-Sin Than, Jacob Fajnor, Jaehong Kim, Elizabeth Mearns, Stacey Kowal, et al.. 2025b. \u201cTwo Approaches for Measuring Treatment Value Under Uncertainty: Estimating Insurance Value and Risk Preferences in Neurology.\u201d In Forum for Health Economics and Policy.","DOI":"10.1515\/fhep-2024-0038"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_070","unstructured":"Social Security Administration. 2023. \u201cPeriod Life Table, 2020, as Used in the 2023 Trustees Report.\u201d https:\/\/www.ssa.gov\/oact\/STATS\/table4c6.html (accessed 19 May, 2023)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_072","unstructured":"U.S. Bureau of Labor Statistics. 2021. \u201cCivilian Labor Force Participation Rate by Age, Sex, Race, and Ethnicity.\u201d https:\/\/www.bls.gov\/emp\/tables\/civilian-labor-force-participation-rate.htm."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_073","unstructured":"U.S. Bureau of Labor Statistics. 2022. \u201cCivilain Workers by Occupational and Industry Group.\u201d https:\/\/www.bls.gov\/news.release\/ecec.t02.htm (accessed 19 May, 2023)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_074","unstructured":"U.S. Bureau of Labor Statistics. 2023. \u201cMeasuring Price Change in the CPI: Meidcal Care.\u201d https:\/\/www.bls.gov\/cpi\/factsheets\/medical-care.htm (accessed 5 April, 2023)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_075","doi-asserted-by":"crossref","unstructured":"Van Dyck, Christopher H., Chad J. Swanson, Paul Aisen, Randall J. Bateman, Christopher Chen, Michelle Gee, Michio Kanekiyo, et al.. 2023. \u201cLecanemab in Early Alzheimer\u2019s Disease.\u201d New England Journal of Medicine 388 (1): 9-21, https:\/\/doi.org\/10.1056\/nejmoa2212948.","DOI":"10.1056\/NEJMoa2212948"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_078","doi-asserted-by":"crossref","unstructured":"Whittington, Melanie D., Jonathan D. Campbell, David Rind, Noemi Fluetsch, Grace A. Lin, and Steven D. Pearson. 2022. \u201cCost-Effectiveness and Value-Based Pricing of Aducanumab for Patients with Early Alzheimer Disease.\u201d Neurology 98 (9): e968\u2013e977. https:\/\/doi.org\/10.1212\/wnl.0000000000013314.","DOI":"10.1212\/WNL.0000000000013314"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_079","doi-asserted-by":"crossref","unstructured":"Wimo, Anders, Ma\u00eblenn Guerchet, Gemma-Claire Ali, Yu-Tzu Wu, A. Matthew Prina, Bengt Winblad, et al.. 2017. \u201cThe Worldwide Costs of Dementia 2015 and Comparisons with 2010.\u201d Alzheimer\u2019s & Dementia 13 (1): 1\u20137. https:\/\/doi.org\/10.1016\/j.jalz.2016.07.150.","DOI":"10.1016\/j.jalz.2016.07.150"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_080","unstructured":"World Health Organization. 2021. \u201cDementia.\u201d Health Topics: Prevalence. https:\/\/www.who.int\/health-topics\/dementia#tab=tab_2 (accessed 6 June, 2025)."},{"key":"2026090110555966580_j_fhep-2025-0034_ref_081","doi-asserted-by":"crossref","unstructured":"Xu, Ruifeng, Ralph P. Insinga, Wendy Golden, and X. Henry Hu. 2011. \u201cEuroqol (EQ-5D) Health Utility Scores for Patients with Migraine.\u201d Quality of Life Research 20 (4): 601\u20138, https:\/\/doi.org\/10.1007\/s11136-010-9783-5.","DOI":"10.1007\/s11136-010-9783-5"},{"key":"2026090110555966580_j_fhep-2025-0034_ref_082","doi-asserted-by":"crossref","unstructured":"Yoon, Connie, Corey Groff, and Olivia Criss. 2024. \u201cLecanemab: A Second in Class Therapy for the Management of Early Alzheimer\u2019s Disease.\u201d Innovations in Pharmacy 15 (1). https:\/\/doi.org\/10.24926\/iip.v15i1.5787.","DOI":"10.24926\/iip.v15i1.5787"}],"container-title":["Forum for Health Economics and Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/fhep-2025-0034\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/fhep-2025-0034\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:56:16Z","timestamp":1788260176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/fhep-2025-0034\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":70,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,8,21]]},"published-print":{"date-parts":[[2026,9,2]]}},"alternative-id":["10.1515\/fhep-2025-0034"],"URL":"https:\/\/doi.org\/10.1515\/fhep-2025-0034","relation":{},"ISSN":["1558-9544"],"issn-type":[{"value":"1558-9544","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}