Equity and budget challenges associated with the employment of anti-amyloid monoclonal antibodies for early Alzheimer's Disease in Italy: A scenario analysis - PubMed

4 hours ago

Anti-amyloid monoclonal antibodies (lecanemab and donanemab) are the first disease-modifying therapies for early symptomatic Alzheimer's disease in Italy.
Italy must decide whether to include these therapies in the Essential Levels of Care (LEA), requiring national reimbursement.
A scenario-based budget impact analysis over three years was conducted using deterministic modeling and implementation frameworks.
An estimated 42,000 patients in Italy are potentially eligible for anti-amyloid therapy.
A moderate uptake scenario (5-10-15% over three years, reaching 14,100 cumulative patients) is identified as the optimal policy target.
The three-year total cost for the moderate scenario is €557.3 million, which is 0.4% of the annual National Health Service budget.
This scenario would achieve a 33.6% penetration of eligible patients and has a high implementation feasibility score (1.5).
Implementation is feasible but requires targeted infrastructure investment, especially in Central and Southern regions, to ensure equitable access.
Key prerequisites for full LEA inclusion include capacity building, clarified reimbursement policies, integrated diagnostic networks, and workforce planning.

Hasty Briefsbeta