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Cost-effectiveness of injectable disease-modifying therapies for the treatment of relapsing forms of multiple sclerosis in Spain

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Abstract

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 €168,629 per QALY gained for IM IFNβ-1a, €231,853 per QALY gained for IFNβ-1b, €295,638 per QALY gained for SC IFNβ-1a, and €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.

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Acknowledgments

This research was funded by Biogen Idec.

Conflict of interest

Carole Dembek and Leigh Ann White are employees and shareholders of Biogen Idec. Andrea Szkurhan, Jayson Quach and Nazia Rashid were paid consultants on the study. M.R. Blasco received consulting fees from Biogen Idec for participation in this research.

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Authors and Affiliations

  1. Avalere Health, 1350 Connecticut Ave, NW Suite 900, Washington, DC, 20036, USA

    Carole Dembek

  2. Biogen Idec, 133 Boston Post Road, Weston, MA, 02493, USA

    Leigh Ann White

  3. Dymaxium, 145 Front Street East, Suite 306, Toronto, ON, M5A 1E3, Canada

    Jayson Quach, Andrea Szkurhan & Nazia Rashid

  4. Hospital Universitario Puerta de Hierro, Manuel de Falla 1, Majadahonda, 28222, Madrid, NA, Spain

    M. R. Blasco

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  1. Carole Dembek
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Correspondence to Carole Dembek.

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Dembek, C., White, L.A., Quach, J. et al. Cost-effectiveness of injectable disease-modifying therapies for the treatment of relapsing forms of multiple sclerosis in Spain. Eur J Health Econ 15, 353–362 (2014). https://doi.org/10.1007/s10198-013-0478-z

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  • DOI: https://doi.org/10.1007/s10198-013-0478-z

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