Evaluating the Long-Term Clinical, Societal, and Economic Outcomes of Ofatumumab Vs Teriflunomide/Interferon Β-1A and the Impact of Early Vs Delayed Ofatumumab Initiation in Relapsing Multiple Sclerosis Patients in Greece

OBJECTIVES: Estimate the long-term clinical, societal, and economic outcomes of ofatumumab vs teriflunomide/interferon β-1a (IFN-β-1a) and evaluate the impact of early (at first line) vs delayed (3-year/5-year delay) ofatumumab initiation in relapsing multiple sclerosis (RMS) patients from a Greek societal perspective.

METHODS: A cost-consequence analysis was conducted using an Expanded Disability Status Scale (EDSS)-based Markov model. Cycle transitions included EDSS progression, improvement or stabilisation, treatment discontinuation, relapse, or death. Treatment effects were applied in the form of delaying disability progression and reducing the number of relapses over a 10-year time horizon. Inputs were sourced from ASCLEPIOS I & II trials, network meta-analysis, published literature, and publicly available sources.

RESULTS: At the end of 10 years, the proportion of patients in the mild disability state (EDSS 0-3) was projected to be higher in the ofatumumab vs teriflunomide/IFN-β-1a cohort (57% vs 44%/43%). Furthermore, patients initiating ofatumumab at the first line were projected to experience fewer relapses (3.79 vs 5.26/5.32), required 23% less informal-care (194 vs 239/239 days), and 11% reduced early retirement vs teriflunomide/IFN-β-1a cohort (35% vs 39%/39%). An early switch (3-year) to ofatumumab (i.e., 3-year teriflunomide/IFN-β-1a + 7-year ofatumumab) vs not switching to ofatumumab (i.e., continuing with teriflunomide/IFN-β-1a for 10 years) was estimated to still result in better patient outcomes (relapses: 4.56 & 4.72 vs 5.26/5.32; informal-care time: 225 & 227 vs 239/239 days; early retirement: 37% & 38% vs 39%/39%). Similar results were seen when ofatumumab was initiated after 5 years (i.e., 5-year teriflunomide/IFN-β-1a + 5-year ofatumumab). Early ofatumumab initiation was projected to result in a slight increase in the drug costs, which gets partially offset by other direct and indirect cost savings vs teriflunomide/IFN-β-1a for all three scenarios.

CONCLUSIONS: Early initiation of and/or switching to ofatumumab was projected to provide long-term clinical, societal, and economic benefits in RMS patients.