Health economic issues in MS.

The objectives of MS treatment are to avoid temporary disability due to relapses and to delay progression to permanent disability. There have been intense debates about whether new and costly MS treatments represent efficient use of resources, and which patients should be treated. Cost-effectiveness analysis attempts to estimate the trade-offs involved and to provide information that will assist the decision-making process. In chronic-progressive diseases, health gains and potential associated economic benefits are often most evident in the long term. Consequently, the potential impact of new treatments must be estimated, using models that project available knowledge into the future. These models can also explore scenarios that provide best value for money (e.g. by defining subgroups or criteria when treatment should be stopped). The different findings obtained by various cost-effectiveness studies of new MS treatments can be explained by the variations in methodological approaches, patient definitions and datasets used. The key is to communicate such differences transparently.