scholarly journals A Comprehensive Cost-Effectiveness Analysis of Treatments for Multiple Sclerosis

2011 ◽  
Vol 13 (3) ◽  
pp. 128-135 ◽  
Author(s):  
Ashley N. Newton ◽  
Christina M. Stica
Keyword(s):  
Multiple Sclerosis ◽  
Cost Effectiveness ◽  
Interferon Beta ◽  
First Line ◽  
Disease Modifying Drugs ◽  
Future Studies ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
The Cost ◽  
Relapsing Remitting Multiple Sclerosis

The purpose of this study was to examine the cost-effectiveness of four disease-modifying drugs (DMDs) used to treat multiple sclerosis (MS): glatiramer acetate (GA; Copaxone), interferon beta-1a (IFNβ-1a) intramuscular (IM) injection (Avonex), IFNβ-1a subcutaneous (SC) injection (Rebif), and interferon beta-1b (IFNβ-1b) SC injection (Betaseron). Cost-effectiveness analyses are useful in countering the financial uncertainties and treatment efficacy concerns faced by people with MS. We conducted simulation analyses of the principal findings of a 2009 study by Goldberg et al. (Goldberg LD, Edwards NC, Fincher C, et al: Comparing the cost-effectiveness of disease-modifying drugs for the first-line treatment of relapsing remitting multiple sclerosis. J Manag Care Pharm. 2009;15:543–555) to frame the researchers' findings from the perspectives of cost-conscious and cost-neutral MS patients. We found that for the cost-conscious consumer, the ranking of most (1) to least (4) preferred DMDs was 1) IFNβ -1a IM (Avonex), 2) GA (Copaxone), 3) IFNβ-1a SC (Rebif), and 4) IFNβ-1b SC (Beta-seron). For the cost-neutral consumer who places priority on effectiveness over costs, the ranking was 1) IFNβ-1a SC (Rebif), 2) IFNβ-1b SC (Betaseron), 3) GA (Copaxone), and 4) IFNβ-1a IM (Avonex). Future studies could examine cost-effectiveness over extended periods of time (eg, 15–20 years) and more closely examine the cost-effectiveness of natalizumab (Tysabri) relative to the four primary DMDs.

scholarly journals [Cost-effectiveness analysis of peginterferon beta-1a in Italian relapsing remitting multiple sclerosis management]

2016 ◽  
Vol 17 (2S) ◽  
pp. 13-36 ◽  
Author(s):  
Sergio Iannazzo ◽  
Laura Santoni ◽  
Cecilia Saleri ◽  
Elisa Puma ◽  
Giulia Vestri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cost Effectiveness ◽  
Interferon Beta ◽  
Sensitivity Analyses ◽  
First Line ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Relapsing Remitting ◽  
The Cost ◽  
Relapsing Remitting Multiple Sclerosis

BACKGROUND: Peginterferon beta-1a is indicated in adult patients for the treatment of relapsing remitting multiple sclerosis (RRMS). The efficacy and safety of peginterferon beta-1a was demonstrated in the placebo-controlled ADVANCE trial.OBJECTIVE: The objective of this study was to assess the cost-effectiveness of peginterferon beta-1a as compared with injectable first-line treatments for RRMS in Italy.METHODS: The cost-effectiveness analysis was developed through a Markov model with lifetime simulation in the perspective of the Italian National Healthcare Service (NHS). It was added an alternative scenario to take into account the Italian societal perspective. Outcomes were measured in terms of life years (LYs), quality adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratio (ICER). The natural progression of the disease was informed by the published literature and previously published modelling exercises. The efficacy of treatments was simulated as reduction of disability progression (EDSS) and relapse rate. Efficacy data were derived from a published network meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. A 3.5% discount rate was applied to costs and outcomes. One-way and probabilistic sensitivity analyses were developed and cost-effectiveness acceptability curves generated.RESULTS: Peginterferon beta-1a was more effective than the comparators in terms of survival (19.94 vs.19.68-19.81 discounted LYs, respectively), and QALYs (9.07 vs. 8.06 and 8.55 discounted QALY, respectively). In the perspective of the Italian NHS, the ICER was € 11,111/QALY vs. interferon beta-1a 30 µg, € 12,604/QALY vs. interferon beta-1a 22 µg, € 10,580/QALY and € 16,702/QALY vs. interferon beta-1b 250 µg and € 22,023/QALY vs. glatiramer acetate 20 mg. Peginterferon beta-1a dominated interferon beta-1a 44 µg. In the societal perspective, peginterferon beta-1a was dominant due to being more effective and with a lower social cost compared to first-line injectable treatments (interferon beta -1a, interferon beta-1b, glatiramer acetate) for RRMS. The outcomes of the sensitivity analyses confirmed the trend of the base case results.CONCLUSIONS: Peginterferon beta-1a shows a favourable pharmaco-economic profile for the treatment of RRMS. Even if an official threshold for the cost-effectiveness does not exist in Italy, the ICER values obtained were far below the commonly accepted thresholds (30,000-50,000 €/per QALY gained).[Article in Italian]

scholarly journals Induction or aggravation of other immune-mediated disorders by disease-modifying therapy in treatment of multiple sclerosis

2019 ◽  
Author(s):  
Seyed Mohammad Baghbanian ◽  
Mohammad Ali Sahraian
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Immunomodulatory Agents ◽  
Disease Modifying Drugs ◽  
Disease Modifying Therapy ◽  
Immune Mediated ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Relapsing Remitting Multiple Sclerosis

Interferon beta (IFN-β) and glatiramer acetate (GA) are the primary therapeutic immunomodulatory agents that interfere with relapsing-remitting multiple sclerosis (RRMS), and the most commonly-used drugs as well. Induction or aggravation of other immune-mediated diseases has been reported following INF-β administration. We have reviewed the reported cases to notify the treating physicians about these rare adverse events. Although co-morbid autoimmune disorders have been reported in patients with MS, the pro-inflammatory role of disease-modifying drugs, especially INF-β, could affect and enhance this co-occurrence. Clinical or laboratory autoimmunity histories suggest the use of GA over INF-β as the treatment of choice.

Sign in / Sign up

Export Citation Format

Share Document