Ξ²-catenin Inhibitor β€” GCEA Societal Value Model
Generalized Cost-Effectiveness Analysis Β· Order-of-Magnitude Societal Value

What a working Ξ²-catenin inhibitor would be worth to the United States

A transparent GCEA estimate of the lifetime societal value of an effective Wnt/Ξ²-catenin:TCF inhibitor β€” modeled on the clinical premise of Parabilis Medicines' zolucatetide. Every assumption below is editable; the answer recomputes live. This is a societal-value question, not a sales forecast or company valuation.

VOLY $150k 2% discount 70 stacked cohorts 100% access US-only Shafrin et al. 2024
Year-1 annual societal value
β€”
chronic + oncology (+ IO)
70-year present value
β€”
discounted at the societal rate
Value delivered post-generic (after yr 14)
β€”
the genericization "gift" to society

Year-1 value by engine

intermediate subtotals
A Β· Chronic maintenance
β€”
70-yr PV β€”
B Β· Oncology survival
β€”
70-yr PV β€”
C Β· IO resensitization
β€”
off

Cumulative discounted value over time

PV accrual
Cumulative discounted PV Year 14 β€” branded period ends Half-life β€” 50% of PV accrued

Where the value comes from

70-yr PV by indication

Engine A β€” Chronic lifelong maintenance

desmoid Β· FAP Β· ACP
IndicationPrevalent poolTreated % Averted med $/pt/yrQoL+prod $/pt/yrYr-1 value70-yr PV
Subtotal
Value/yr = pool Γ— treated% Γ— (averted med cost + QoL/productivity). Pool grows with population only. Recurs every year for life.

Engine B β€” Oncology survival

per-responder lifetime value
IndicationAnnual incidenceAddress %Benefit % LY gainedAvert $kProd $kCare $kYr-1 value70-yr PV
Subtotal
Per responder V = (LY Γ— VOLY) + averted med + productivity + caregiver. Annual value = incidence Γ— address% Γ— benefit% Γ— V. Counts grow with population + aging.

Engine C β€” Immune resensitization

layer OFF
Conversion targetAnnual incidenceConversion % Durable LYAvert $kProd $kCare $kYr-1 value70-yr PV
Subtotal
Double-counting flag: "MSS CRC→IO" overlaps the same patients as base-case CRC via a different mechanism. Durable IO responses behave like functional cures, so LY/responder sits well above the cytostatic base case. Reduce conversion % to stay conservative.

One-way sensitivity β€” CRC

benefit % Γ— LY gained β†’ 70-yr PV
Each cell holds all else fixed and recomputes total 70-yr PV with CRC's benefit% (columns) and life-years gained (rows) set to the shown values. Current setting highlighted.

Methodology & notes

show your work

This model follows the Generalized Cost-Effectiveness Analysis (GCEA) framework of Shafrin et al., "Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices," Forum for Health Economics & Policy (2024). It applies the guide's recommended choices: a 2% societal discount rate, 70 stacked annual cohorts over a 70-year horizon, dynamic net health system costs via genericization, and dynamic prevalence through population growth and aging.

Two value engines

Engine A β€” chronic lifelong maintenance (desmoid, FAP, and adamantinomatous craniopharyngioma [ACP] β€” a near-uniformly CTNNB1/Ξ²-catenin-driven tumor managed long-term). A prevalent pool is treated continuously; value recurs every year for life. The pool grows with population only.

value_t = pool Γ— pop_factor(t) Γ— access Γ— treated% Γ— (averted_med Γ— medcost_factor(t) + QoL_prod)

Engine B β€” oncology survival (CRC, HCC, rare low-complexity, and a broad "other Ξ²-catenin" bucket). Each responder gets a one-time lifetime value; the count of new responders grows with population and aging.

V_responder = LY Γ— VOLY + averted_med Γ— medcost_factor(t) + productivity + caregiver value_t = incidence Γ— pop_factor(t) Γ— age_factor(t) Γ— access Γ— address% Γ— benefit% Γ— V_responder

Engine C β€” immune resensitization (optional, additive). Conversions of IO-refractory tumors into durable responders; durable LY set above the cytostatic base case because durable IO responses behave like functional cures.

Integration & discounting

Each stream is computed year by year for t = 0…Hβˆ’1, compounded at its own real growth rate, then discounted at the societal rate: PV = Ξ£ flow_t / (1+r)^t. The post-generic share is the fraction of PV arriving in year 14 and later β€” the value that accrues to society after the drug's own price has collapsed toward marginal cost.

Growth, with taper (not flat for 70 years)

Population growth starts at the slider value and tapers linearly to zero by ~year 50. The aging uplift to cancer incidence starts at its slider value, holds through ~year 15, then fades to zero by ~year 40. Real medical-cost growth applies only to averted-medical-cost terms, so averted hospitalizations and surgeries are worth more later; VOLY and productivity are held flat in real terms.

Drug cost as a transfer

For a societal-value estimate the drug's own acquisition cost is treated as a transfer β‰ˆ 0 and excluded. The drug is branded ~14 years, then its price collapses toward marginal cost; societal value persists after that. The model therefore reports how much of the total value lands in the post-generic period.

GCEA petals: included vs. conservatively omitted

βœ“ INPatient-centered health (LY Γ— VOLY)
βœ“ INDynamic net health system costs (genericization)
βœ“ INDynamic prevalence (pop growth + aging)
βœ“ INSocietal discount rate (2% base)
βœ“ INProductivity (market + non-market)
βœ“ INFamily & caregiver spillover
βœ• OUTInsurance value / disease-risk reduction
βœ• OUTValue of hope / outcome certainty
βœ• OUTOption value
βœ• OUTScientific spillover
βœ• OUTEquity weighting
βœ• OUTEx-US patients (global is a multiple higher)

The guide treats every omitted petal as real value, so excluding them biases this estimate downward. They are upside left on the table.

Required caveats. This is an order-of-magnitude estimate built on public data and explicit, editable assumptions. It is not an investment recommendation and not a sales forecast; societal value to all of society is conceptually distinct from revenue or company value. It should be independently verified before any use. Results are US-only β€” global societal value would be a multiple higher. Common-cancer efficacy is a modest combination-agent assumption, not observed data; only desmoid/FAP signals are treated as observed. AI-generated content must be independently verified and cannot be the sole basis for an investment decision.
Per RA Capital policy: AI-generated content like this must be independently verified before use, cannot be the sole basis for an investment decision, and any final output used in an investment decision must be retained per RAC's recordkeeping policy. Questions on permissibility β†’ legal@racap.com or thecompliancecrew@racap.com.
GCEA order-of-magnitude societal-value model Β· method per Shafrin et al. (2024), doi:10.1515/fhep-2024-0014 Β· clinical premise per Parabilis Medicines zolucatetide disclosures Β· built as an inspectable estimate, not advice.