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A USC Schaeffer Center model estimates donanemab could generate $104,900 in lifetime societal value per person when started at the timing used in a clinical trial, rising to $138,300 if begun two years earlier. The estimates include health and economic benefits but exclude drug, screening and monitoring costs, and depend on assumptions about how long treatment effects last.
A new USC Schaeffer Center model estimates that treating eligible people with Alzheimer’s disease using donanemab could generate greater lifetime health and economic benefits when treatment starts earlier. The modeled societal value rose by 32%, to $138,300 per person, when treatment began two years sooner than in the clinical-trial scenario; the estimate does not subtract the costs of the drug or the screening and monitoring needed to provide it.
The study, published Oct. 7 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, used a dynamic microsimulation model to project outcomes over patients’ lifetimes. Researchers compared three scenarios for a group resembling participants in a pivotal Phase 3 trial: treatment at the trial’s timing, treatment two years earlier, and no treatment. The model assumed donanemab slowed disease progression by 29%, matching the trial’s reported effect versus placebo after 18 months.
Compared with no treatment, the trial-timing scenario was projected to add about 0.3 years of life, reduce time lived with severe dementia by one year, and provide 0.37 additional disability-free years and 0.63 more years living in the community. Researchers valued those benefits at $104,900 per person over a lifetime. The estimate included $52,300 in health-related quality-of-life gains, $23,800 from reduced unpaid caregiving and $22,200 in medical-cost offsets, much of the latter accruing to Medicaid. The model estimated Medicaid costs would fall by about $1,640 per person annually, or 13%.
When treatment started two years earlier, the modeled lifetime value rose to $138,300 per person. A separate scenario incorporating a potentially stronger treatment effect put the estimate at $179,400, 71% above the trial-timing scenario. That higher figure is a projection based on emerging evidence, not an observed result. In a conservative case where treatment effects lasted four years rather than for the rest of a patient’s life, estimated value fell to $49,100 for the trial-timing scenario and $56,400 for earlier treatment.
Earlier Diagnosis Could Change Treatment Value
The findings put a potential economic value on reducing the time between the onset of symptoms and diagnosis. Alzheimer’s is diagnosed an average of 3.5 years after symptoms begin, according to the study’s report. If patients are identified sooner and are eligible for treatment, they may start while the modeled benefit is greater. The analysis suggests that earlier care could affect not only patients’ health and independence but also unpaid caregivers and public health spending.
Those figures are not a calculation of net savings or a recommendation to treat everyone earlier. The estimates exclude the costs of donanemab and the screening and monitoring required to deliver it. Policymakers and health systems would need to weigh those expenses, treatment eligibility and actual patient outcomes against the modeled benefits before drawing conclusions about affordability or access.
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Diagnosis Delays Shape the Model
The researchers used a model developed for the USC Schaeffer Center’s U.S. Cost of Dementia Project, a federally funded effort to estimate dementia’s total costs. They drew on national health surveys and research on dementia progression to project cognitive status and lifetime outcomes. The modeled treatment group was designed to resemble participants in the donanemab Phase 3 trial, rather than every person with Alzheimer’s disease.
The report estimates that Alzheimer’s and related dementias will cost the United States $818 billion in 2026, with costs expected to rise as the population ages. It also points to FDA-approved blood-based biomarker tests and newer digital cognitive assessments as tools that could help identify disease earlier. These developments may affect how patients are diagnosed and considered for treatment, but the model does not establish how widely those tools will be used or whether they will shorten delays in practice.
The researchers also considered hypothetical future treatments. A drug slowing progression by 50% was assigned a modeled lifetime social value of $208,700 to $276,700, depending on when treatment began. A hypothetical treatment that completely halted progression was valued at $530,000 to $648,300. Those scenarios describe model outputs, not available therapies or established clinical outcomes; the report says more than 150 drugs are undergoing clinical testing.
“Our research suggests that investments in early detection could help ensure that patients start treatments when they’re more likely to provide the greatest benefit to patients and society.”
— Jack Chapel, lead author, USC Schaeffer Center scholar and assistant research professor at the USC Price School of Public Policy
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Drug Costs and Durability Remain Open
The study estimates value under specified assumptions; it does not show that earlier treatment will produce the same gains for every patient in routine care. How long donanemab’s effects last is uncertain. The modeled value dropped by about half in the scenario where benefits lasted four years rather than a patient’s remaining lifetime, although earlier treatment still had a higher estimate in that scenario.
The analysis also excludes the drug’s price and the costs of identifying, screening and monitoring patients. It does not establish whether earlier testing would be cost-effective after those expenses, how many people would qualify, or how quickly diagnosis could be advanced. The stronger-effect scenario and estimates for hypothetical future drugs are projections, not confirmed treatment outcomes.
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Evidence and Access Will Shape Impact
The next steps are further clinical evidence on the duration and size of treatment benefits, alongside real-world evidence about who is diagnosed, treated and monitored. The report does not specify a date for a follow-up study or a policy decision. As blood-based tests and digital assessments enter use, their effect on diagnosis timing and access will need to be measured, as will the costs of delivering treatment.
For now, the findings offer policymakers and health systems a modeled comparison of treatment timing—not proof of net savings or a guarantee of individual benefit. Decisions about expanding early detection and access will depend on clinical evidence, eligibility, costs and whether modeled gains are borne out in practice.
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Key Questions
What did the new Alzheimer’s modeling study find?
The USC Schaeffer Center model estimated that donanemab’s lifetime societal value could rise from $104,900 to $138,300 per person if treatment began two years earlier than in the clinical-trial scenario. These are modeled estimates, not observed outcomes for all patients.
What does “societal value” include in the estimate?
The estimate combines modeled health-related quality-of-life gains, reduced unpaid caregiving and medical-cost offsets. It does not include the drug, screening or monitoring costs needed to provide treatment.
Does the study show that donanemab saves money overall?
No. The model estimated some medical-cost offsets, including lower Medicaid costs, but excluded treatment and delivery expenses. It does not establish that the therapy produces net savings after all costs are counted.
Why might starting treatment earlier matter?
The model assumed treatment slows disease progression and estimated larger benefits when it starts earlier. The report notes that Alzheimer’s is diagnosed an average of 3.5 years after symptoms appear, but it does not show that every patient can be diagnosed or treated sooner.
How certain are the projected benefits?
They depend on assumptions about treatment effect and duration. In a scenario where benefits lasted four years rather than for the rest of a patient’s life, the modeled value was substantially lower. The researchers say the duration of benefit remains uncertain.
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