ECONOMIC VALUE OF RELAPSE RATE REDUCTION WITH OFATUMUMAB VERSUS COMPARATOR DISEASE-MODIFYING THERAPIES IN RELAPSING MULTIPLE SCLEROSIS: A FIVE-YEAR BUDGET IMPACT ANALYSIS WITH CLINICAL OUTCOME OFFSETS
Author(s)
Omar Maoujoud, PhD, MD1, sanaa haouraji, Msc2;
1Research team of Pharmacoeconomics & Pharmacoepidemiology, Moroccan Society of health economics (SMEPS), Faculty of Medicine, Mohamed V university, Rabat, Morocco, 2EOS Executive Lab, Casablanca, Morocco
1Research team of Pharmacoeconomics & Pharmacoepidemiology, Moroccan Society of health economics (SMEPS), Faculty of Medicine, Mohamed V university, Rabat, Morocco, 2EOS Executive Lab, Casablanca, Morocco
OBJECTIVES: Annualized relapse rate (ARR) reduction represents the primary efficacy endpoint for disease-modifying therapies (DMTs) in relapsing multiple sclerosis (RMS). Ofatumumab demonstrated the lowest ARR among approved DMTs in pivotal trials. This analysis quantified the economic value of ARR reduction with ofatumumab introduction from the Moroccan payer perspective over five years (2026-2030)
METHODS: A budget impact model with integrated clinical outcome offsets was developed following ISPOR guidelines. Target population: 2,182 RMS patients annually. Comparator ARRs from phase III trials and literature: ofatumumab 0.11 (ASCLEPIOS I/II, Hauser NEJM 2020); interferon β-1a IM 0.61; interferon β-1a SC 0.86; teriflunomide 0.37; fingolimod 0.18; natalizumab 0.25; rituximab 0.20. Weighted comparator ARR was 0.404. Market share projections: ofatumumab uptake from 3.1% (2026) to 25.6% (2030), yielding 1,847 patient-years. Relapse cost: $1,000-$1,200 (conservative-base case), comprising corticosteroids, hospitalization (30% severe), imaging, and rehabilitation. Relapses were calculated using differential methodology: Relapses_avoided = Σ[Patients_comparator × ARR_comparator] − Σ[Patients_ofatumumab × ARR_ofatumumab]. Sensitivity analyses tested relapse costs ($800-$2,000) and market uptake scenarios.
RESULTS: Weighted portfolio ARR decreased from 0.404 (without ofatumumab) to 0.341 (with ofatumumab) by year five, representing 15.6% reduction. Total relapses over five years: 4,500 (without) versus 4,038 (with ofatumumab); 462 relapses avoided (10.3% reduction). Annual relapses avoided increased progressively: 20 (2026), 70 (2027), 102 (2028), 125 (2029), 144 (2030). Economic value of avoided relapses: $462,000-$554,000 (conservative-base scenarios). Additional offsets: administration savings $370,000 (self-injection versus infusions). Total five-year offsets: $832,000-$1,016,000, reducing gross budget impact by 23-28%. Net budget impact: $2.76 million (+2.04% of RMS budget) versus $3.60 million gross. Sensitivity analysis confirmed robustness: even at lowest relapse cost ($800), savings reached $370,000.
CONCLUSIONS: Ofatumumab's superior ARR profile (0.11, lowest in class) generates substantial clinical value through relapse avoidance, translating into quantifiable cost offsets that reduce net budget impact by approximately one-quarter. These findings support value-based pricing negotiations incorporating ARR-driven outcomes
METHODS: A budget impact model with integrated clinical outcome offsets was developed following ISPOR guidelines. Target population: 2,182 RMS patients annually. Comparator ARRs from phase III trials and literature: ofatumumab 0.11 (ASCLEPIOS I/II, Hauser NEJM 2020); interferon β-1a IM 0.61; interferon β-1a SC 0.86; teriflunomide 0.37; fingolimod 0.18; natalizumab 0.25; rituximab 0.20. Weighted comparator ARR was 0.404. Market share projections: ofatumumab uptake from 3.1% (2026) to 25.6% (2030), yielding 1,847 patient-years. Relapse cost: $1,000-$1,200 (conservative-base case), comprising corticosteroids, hospitalization (30% severe), imaging, and rehabilitation. Relapses were calculated using differential methodology: Relapses_avoided = Σ[Patients_comparator × ARR_comparator] − Σ[Patients_ofatumumab × ARR_ofatumumab]. Sensitivity analyses tested relapse costs ($800-$2,000) and market uptake scenarios.
RESULTS: Weighted portfolio ARR decreased from 0.404 (without ofatumumab) to 0.341 (with ofatumumab) by year five, representing 15.6% reduction. Total relapses over five years: 4,500 (without) versus 4,038 (with ofatumumab); 462 relapses avoided (10.3% reduction). Annual relapses avoided increased progressively: 20 (2026), 70 (2027), 102 (2028), 125 (2029), 144 (2030). Economic value of avoided relapses: $462,000-$554,000 (conservative-base scenarios). Additional offsets: administration savings $370,000 (self-injection versus infusions). Total five-year offsets: $832,000-$1,016,000, reducing gross budget impact by 23-28%. Net budget impact: $2.76 million (+2.04% of RMS budget) versus $3.60 million gross. Sensitivity analysis confirmed robustness: even at lowest relapse cost ($800), savings reached $370,000.
CONCLUSIONS: Ofatumumab's superior ARR profile (0.11, lowest in class) generates substantial clinical value through relapse avoidance, translating into quantifiable cost offsets that reduce net budget impact by approximately one-quarter. These findings support value-based pricing negotiations incorporating ARR-driven outcomes
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE33
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Novel & Social Elements of Value
Disease
SDC: Neurological Disorders