On 12 December, researchers from the USA published a systematic review on the cost-effectiveness of testing biofluid biomarkers to diagnose Alzheimer’s disease in the European Journal of Health Economics. Due to the world-wide high prevalence of Alzheimer’s disease (AD) and declining effectiveness of treatment as the disease progresses a timely diagnosis is of vital importance. As new biofluid biomarkers in patients’ blood and cerebrospinal fluid (CSF) emerge as diagnostic tools, the question of their cost-effectiveness plays an important role for their implementation in healthcare systems. The researchers therefore searched for studies in public data bases (PubMed, Embase, Cochrane Library, and Web of Science) for studies. The identified papers were then matched against the predefined inclusion criteria (English, conducted an economic evaluation of CSF or blood biomarker testing to diagnose AD, and provided economic outcomes).
Subsequently, the team assessed their quality, based on the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) criteria, which were met to about 80% in the nine included studies, although information on patient engagement was missing in all of them. Out of the nine included studies, six evaluated CSF biomarker tests and an additional three were focused on blood biomarker tests. The team found that CSF biomarker tests were mostly cost-effective compared to neurocognitive assessments or neuroimaging, while blood biomarker tests showed mixed results. The most important cost-effectiveness contributors they identified were AD prevalence, diagnostic accuracy, and treatment effectiveness. Concluding, the researchers suggest that their review supports the idea that biofluid biomarker testing could be cost-effective to diagnose AD but they also highlight that there is a lack of trial-based economic evaluations, while model-based studies are a valuable starting point. Hence, they underline that future evaluations should incorporate patient-centered outcomes and consider the emotional value as well as other socio-economic factors that affect patients and families affected by AD. The paper has been published open access and can be read here:
https://link.springer.com/article/10.1007/s10198-025-01877-1