COST-EFFECTIVENESS ANALYSIS OF UBLITUXIMAB FOR THE TREATMENT OF RELAPSING REMITTING MULTIPLE SCLEROSIS

OBJECTIVES: Ublituximab is an anti CD20 monoclonal antibody indicated for the treatment of relapsing-remitting multiple sclerosis (RRMS). Along with ofatumumab, ocrelizumab and natalizumab, ublituximab is considered a highly efficacious therapy showing clinically meaningful reductions in annualized relapse rate (ARR). Given the high costs associated with these disease-modifying therapies (DMTs), cost-effectiveness analyses are essential to evaluate their overall value in RRMS management. This study aims to assess the cost-effectiveness of ublituximab to ofatumumab, ocrelizumab and natalizumab from US third-party payer perspective.
METHODS: The analysis was conducted using two static decision-analytic models with a 1-year time horizon. In Model 1, ublituximab was compared with ofatumumab, ocrelizumab and natalizumab using weighted baseline ARR derived from phase III clinical trials. This approach was utilized as each intervention was evaluated against different comparators across trials. In Model 2, ublituximab was compared with ofatumumab using weighted ARR for teriflunomide, as both treatments were evaluated against the same active comparator in phase III clinical trials. Outcomes included total per patient treatment costs, cost per relapse avoided, and incremental cost-effectiveness ratios (ICERs) reported as incremental cost per relapse avoided. Sensitivity analysis was conducted to evaluate the robustness of the results to uncertainty in key model inputs and structural assumptions.
RESULTS: In Model 1, ublituximab ($119,620.78; 1.21) dominated ofatumumab ($141,241.88; 1.15) and ocrelizumab ($131,736; 1.16) while natalizumab ($117,914.09; 1.3) dominated ublituximab. In Model 2, ublituximab ($119,664; 0.117) was associated with a higher ICER of $18,170,729 per relapse avoided compared to ofatumumab ($141,222; 0.118).
CONCLUSIONS: Results from Models 1 and 2 highlight the sensitivity of cost-effectiveness outcomes to comparator selection and indirect comparison methodology, underscoring the importance of robust comparative effectiveness evidence when evaluating high-efficacy DMTs for RRMS.