Budget Impact Analysis of Dimethyl Fumarate for the Treatment of Relapsing/Remitting Multiple Sclerosis in Iraq
Author(s)
Rihab Al-Homsi, Pharm.D1, Emad Aldaoud, MBAn Pharm.D2, Maria Al-Zoubi, B.Pharm1, Sarwat Hasan, B.Pharm2.
1Hikma Pharmaceuticals, Amman, Jordan, 2Hikma Pharmaceuticals, Erbil, Iraq.
1Hikma Pharmaceuticals, Amman, Jordan, 2Hikma Pharmaceuticals, Erbil, Iraq.
OBJECTIVES: Multiple sclerosis (MS) is an immune-mediated, inflammatory, demyelinating disease of the central nervous system that can lead to physical disability, cognitive impairment, and decreased quality of life. Relapsing-remitting MS (RRMS) is the most common type of MS at onset. This study assesses the financial impact of introducing Dimethyl Fumarate (DMF) into Iraqi public formulary for RRMS, using budget impact model.
METHODS: A 5-year budget impact analysis was conducted from Iraqi public payer perspective. We evaluated the annual financial consequences of adding DMF to the existing therapies in the public formulary which included: Interferon βeta 1B Injection, Interferon βeta 1A Injection, Teriflunomide tablets, Fingolimod capsules, Natalizumab injection and Ocrelizumab injection. Existing therapies and their current market shares were sourced from AMS Analytics Q1 FY25 report for Kimadia, the Iraqi governmental agency that regulates the import and distribution of pharmaceuticals and medical equipment. Current tender prices were estimated from the total number of units awarded and total value awarded in 2024, as reported in AMS Analytics Q1 FY25 report for Kimadia. Two uptake scenarios were considered: DMF capturing 10% or 30% of total patients using interferons and oral therapies annually, with no uptake from patients using Natalizumab or Ocrelizumab for both scenarios. RRMS prevalent and incident cases were estimated using AMS Analytics data and local epidemiological sources. Only drug acquisition costs were considered.
RESULTS: Introducing DMF resulted in cumulative 5-year savings of USD 3.95 million at 10% market share and USD 11.84 million at 30% share, with annual budget impact of -4% in the first year and -3% in subsequent years (10% share), and -11% in the first year and -10% thereafter (30% share).
CONCLUSIONS: Adding DMF to Iraqi public formulary for treating RRMS is associated with substantial cost-savings to the healthcare budget. These findings may support more efficient allocation of healthcare resources in Iraq.
METHODS: A 5-year budget impact analysis was conducted from Iraqi public payer perspective. We evaluated the annual financial consequences of adding DMF to the existing therapies in the public formulary which included: Interferon βeta 1B Injection, Interferon βeta 1A Injection, Teriflunomide tablets, Fingolimod capsules, Natalizumab injection and Ocrelizumab injection. Existing therapies and their current market shares were sourced from AMS Analytics Q1 FY25 report for Kimadia, the Iraqi governmental agency that regulates the import and distribution of pharmaceuticals and medical equipment. Current tender prices were estimated from the total number of units awarded and total value awarded in 2024, as reported in AMS Analytics Q1 FY25 report for Kimadia. Two uptake scenarios were considered: DMF capturing 10% or 30% of total patients using interferons and oral therapies annually, with no uptake from patients using Natalizumab or Ocrelizumab for both scenarios. RRMS prevalent and incident cases were estimated using AMS Analytics data and local epidemiological sources. Only drug acquisition costs were considered.
RESULTS: Introducing DMF resulted in cumulative 5-year savings of USD 3.95 million at 10% market share and USD 11.84 million at 30% share, with annual budget impact of -4% in the first year and -3% in subsequent years (10% share), and -11% in the first year and -10% thereafter (30% share).
CONCLUSIONS: Adding DMF to Iraqi public formulary for treating RRMS is associated with substantial cost-savings to the healthcare budget. These findings may support more efficient allocation of healthcare resources in Iraq.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE81
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Neurological Disorders