Utility, Costs and Cost-Utility of Amyloid-PET in the Diagnostic Process of Memory Clinic Patients: A Trial-Based Economic Evaluation From AMYPAD-DPMS

Ingrid S van Maurik ^1,2,3,4, Daniele Altomare ^5,6,7, Lyduine E Collij ^8,9

¹Alzheimer Center Amsterdam, Neurology Amsterdam UMC Location VUmc Vrije Universiteit Amsterdam, the Netherlands.
²Amsterdam Neuroscience, Neurodegeneration Amsterdam, the Netherlands.
³Amsterdam UMC, Vrije Universiteit Amsterdam Department of Epidemiology and Data Science Amsterdam Public Health Institute Amsterdam, the Netherlands.
⁴Northwest Academy, Northwest Clinics Alkmaar, Alkmaar, the Netherlands.
⁵Competence Centre on Ageing (CCA), Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
⁶Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.
⁷Geneva Memory Center, Geneva University Hospitals, Geneva, Switzerland.
⁸Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, the Netherlands.
⁹Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands.
¹⁰Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, University Hospitals of Geneva, Geneva, Switzerland.
¹¹NIMTlab, Faculty of Medicine, Geneva University, Geneva, Switzerland.
¹²CIBM Center for Biomedical Imaging, Geneva, Switzerland.
¹³Leenaards Memory Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
¹⁴EQT Life Sciences, Amsterdam, the Netherlands.
¹⁵GE Healthcare, Amersham, UK.
¹⁶Life Molecular Imaging GmbH, Berlin, Germany.
¹⁷Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
¹⁸Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
¹⁹Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, (CIBER-BBN), Barcelona, Spain.
²⁰H. Lundbeck A/S, Copenhagen, Denmark.
²¹Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
²²Division of Neurology, Department of Brain Sciences, Imperial College London, UK.
²³Division of Psychiatry, University College London, London, UK.
²⁴St. Margaret's Hospital, Essex Partnership University NHS Foundation Trust, Essex, UK.
²⁵Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
²⁶German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.
²⁷Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
²⁸Institute of Neuroscience and Medicine (INM-2), molecular Organization of the Brain, Forschungszentrum Jülich, Germany.
²⁹Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.
³⁰Toulouse NeuroImaging Center (ToNIC), Inserm, Université Paul Sabatier, Toulouse, France.
³¹Toulouse NeuroImaging Center (ToNIC), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France.
³²Gérontopôle, Department of Geriatrics, Toulouse University Hospital, Toulouse, France.
³³Maintain Aging Research Team, CERPOP, Inserm, Université Paul Sabatier, Toulouse, France.
³⁴Department of Neurobiology, Care Sciences and Society, Center of Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
³⁵Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
³⁶Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, UK.

⁰Alzheimer Center Amsterdam, Neurology Amsterdam UMC Location VUmc Vrije Universiteit Amsterdam, the Netherlands.

European Journal of Neurology +

|

June 24, 2025

View abstract on PubMed

Summary

Early amyloid positron emission tomography (PET) in memory clinic patients did not prove cost-effective after six months. While providing an earlier diagnosis, the higher costs of amyloid-PET were not justified by significant health outcome improvements.

Area Of Science

Neurology
Health Economics
Medical Imaging

Background

Amyloid positron emission tomography (PET) aids accurate diagnosis in memory clinics but isn't routine due to cost-utility evidence gaps.
This study evaluates the cost-utility of early versus no amyloid-PET in memory clinic patient work-ups.

Purpose Of The Study

To assess the cost-utility of early amyloid-PET compared to no amyloid-PET in the diagnostic work-up of memory clinic patients.
To determine if early amyloid-PET improves health outcomes (EQ-5D-5L, VAS, ICECAP-O) and is cost-effective at 6 months.

Main Methods

Cost-utility analysis of patients from the AMYPAD-DPMS trial across six European memory clinics.
Randomization into early amyloid-PET (ARM1) or no amyloid-PET (ARM2) groups, with data collected at baseline and 6 months.
Calculation of incremental cost-effectiveness ratio (ICER) from a societal perspective using EQ-5D-5L.

Main Results

Amyloid-PET led to higher costs at 6 months (ARM1 vs. ARM2: €1384 increase).
No significant differences were observed in quality of life measures (EQ-5D-5L, VAS, ICECAP-O) between groups.
The incremental cost-effectiveness ratio (ICER) was €461,333 per QALY, indicating unfavorable cost-utility.

Conclusions

Early amyloid-PET in memory clinic patients is not cost-effective at the 6-month follow-up.
The diagnostic benefits of early amyloid-PET do not currently outweigh its increased costs.
Cost-utility needs re-evaluation for selecting patients for anti-amyloid therapies.

Keywords:

Alzheimer's disease amyloid‐PET cost‐utility early diagnosis

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