OBJECTIVE: To compare the cost-effectiveness of injectable disease-modifying therapies (DMTs) for the first-line treatment of relapsing-remitting multiple sclerosis (RRMS) in Spain. METHODS: A Markov model was developed to estimate the cost-effectiveness of intramuscular interferon beta-1a (IM IFNβ-1a), subcutaneous interferon beta-1a (SC IFNβ-1a), interferon beta-1b (IFNβ-1b) and glatiramer acetate (GA) relative to best supportive care in a hypothetical cohort of 1,000 RRMS patients in Spain. The model was developed from a societal perspective with a time horizon of 30 years. Natural history and clinical trial data were used to model relapse rates and disease progression. Cost and utility data were obtained from a published survey of multiple sclerosis patients in Spain. The primary outcome measure was cost per quality-adjusted life year (QALY) gained. Univariate and probabilistic sensitivity analyses were performed. RESULTS: Compared to best supportive care, the base case cost-effectiveness was <euro>168,629 per QALY gained for IM IFNβ-1a, <euro>231,853 per QALY gained for IFNβ-1b, <euro>295,638 per QALY gained for SC IFNβ-1a, and <euro>318,818 per QALY gained for GA. Results were most sensitive to changes in DMT cost, utility values and treatment effect. CONCLUSIONS: In our cost-effectiveness analysis of first-line injectable DMTs in Spain, we found IM IFNβ-1a to be more cost-effective than SC IFNβ-1a, IFNβ-1b or GA. Sensitivity analyses confirmed the robustness of these results.
OBJECTIVE: To compare the cost-effectiveness of injectable disease-modifying therapies (DMTs) for the first-line treatment of relapsing-remitting multiple sclerosis (RRMS) in Spain. METHODS: A Markov model was developed to estimate the cost-effectiveness of intramuscular interferon beta-1a (IM IFNβ-1a), subcutaneous interferon beta-1a (SC IFNβ-1a), interferon beta-1b (IFNβ-1b) and glatiramer acetate (GA) relative to best supportive care in a hypothetical cohort of 1,000 RRMSpatients in Spain. The model was developed from a societal perspective with a time horizon of 30 years. Natural history and clinical trial data were used to model relapse rates and disease progression. Cost and utility data were obtained from a published survey of multiple sclerosispatients in Spain. The primary outcome measure was cost per quality-adjusted life year (QALY) gained. Univariate and probabilistic sensitivity analyses were performed. RESULTS: Compared to best supportive care, the base case cost-effectiveness was <euro>168,629 per QALY gained for IM IFNβ-1a, <euro>231,853 per QALY gained for IFNβ-1b, <euro>295,638 per QALY gained for SC IFNβ-1a, and <euro>318,818 per QALY gained for GA. Results were most sensitive to changes in DMT cost, utility values and treatment effect. CONCLUSIONS: In our cost-effectiveness analysis of first-line injectable DMTs in Spain, we found IM IFNβ-1a to be more cost-effective than SC IFNβ-1a, IFNβ-1b or GA. Sensitivity analyses confirmed the robustness of these results.
Authors: K Noyes; A Bajorska; A Chappel; S R Schwid; L R Mehta; B Weinstock-Guttman; R G Holloway; A W Dick Journal: Neurology Date: 2011-07-20 Impact factor: 9.910
Authors: Christopher Bell; Jonathan Graham; Stephanie Earnshaw; Merrikay Oleen-Burkey; Jane Castelli-Haley; Kenneth Johnson Journal: J Manag Care Pharm Date: 2007-04
Authors: Stephanie R Earnshaw; Jonathan Graham; MerriKay Oleen-Burkey; Jane Castelli-Haley; Kenneth Johnson Journal: Appl Health Econ Health Policy Date: 2009 Impact factor: 2.561
Authors: L D Jacobs; D L Cookfair; R A Rudick; R M Herndon; J R Richert; A M Salazar; J S Fischer; D E Goodkin; C V Granger; J H Simon; J J Alam; D M Bartoszak; D N Bourdette; J Braiman; C M Brownscheidle; M E Coats; S L Cohan; D S Dougherty; R P Kinkel; M K Mass; F E Munschauer; R L Priore; P M Pullicino; B J Scherokman; R H Whitham Journal: Ann Neurol Date: 1996-03 Impact factor: 10.422