IPECAD Open-Source Model Framework

IPECAD Open-Source Model Framework supports the health-economic evaluation of early Alzheimer's disease treatment through an open-source cohort state-transition model that enables transparency, cross-validation, and additional uncertainty analyses.

Key Features:

• Open-source implementation: The framework is available as R code, spreadsheet, and web-based version.
• Cohort state-transition model: The model uses a categorized composite domain of cognition and function.
• Cross-validation capability: The framework replicates existing reference models and implements features of other models such as the Institute for Clinical and Economic Review (ICER) model and the Alzheimer's Disease Archimedes Condition-Event Simulator (AD-ACE) model for cross-validation.
• Uncertainty analysis: Additional uncertainty scenarios can be performed on choice of efficacy outcome from trial, natural disease progression, treatment effect waning and stopping rules, and other methodological choices.

Scientific Applications:

• Health technology assessment: The framework supports reimbursement decisions for new Alzheimer's disease treatments by informing economic evaluations.
• Model cross-validation: The framework enables researchers and decision makers to cross-validate other Health Technology Assessment submission models, demonstrated through replication of an existing reference model and implementation of ICER and AD-ACE model features assessing lecanemab treatment.
• Uncertainty analysis in early Alzheimer's disease treatment: The framework addresses uncertainty in assumptions on treatment effect waning and stopping rules and choice of efficacy outcome from trial.

Methodology:

A cohort state-transition model using a categorized composite domain (cognition and function) was developed by replicating an existing reference model and testing it for internal validity, then implementing features of existing ICER and AD-ACE models assessing lecanemab treatment for model cross-validation.