Cost-Utility Analysis of Ocrelizumab for Treating Relapsing Multiple Sclerosis in Austria
Author(s)
Evelyn Walter, PhD1, Christoph Goger, Mag.2, Veronika Mikl, Mag.2.
1CEO, Institute for Pharmacoeconomic Research, Vienna, Austria, 2Roche Austria GmbH, Vienna, Austria.
1CEO, Institute for Pharmacoeconomic Research, Vienna, Austria, 2Roche Austria GmbH, Vienna, Austria.
OBJECTIVES: Multiple Sclerosis (MS), a disease that predominantly affects young, working-age adults, impacts 14,470 individuals in Austria (prevalence: 159/100,000; 68.48% relapsing-remitting MS [RRMS]). Ocrelizumab is approved for the treatment of RMS and PPMS and has a well established efficacy and safety profile. This study aims to assess the cost-utility of ocrelizumab versus alternative RRMS therapies under different treatment algorithms and to highlight the broader value of this highly effective therapy.
METHODS: The primary outcome was the modelled incremental cost-effectiveness ratio (ICER; €/quality-adjusted life-year [QALY] gained, threshold 25,000 €, discount rate 3%) over 10 years from the societal perspective. A Markov model with 3-moth cycles captured patient transitions between Expanded Disability Status Scale (EDSS) states, conversion to secondary progressive MS, relapses, adverse events, and death. Natural history and transition probabilities were derived from a published network meta-analysis. Treatment switching and discontinuation were also considered. Resource utilization and costs reflected Austrian clinical practice and local tariffs. Utility inputs were drawn from literature. Alternative treatment strategies were modelled in pre-treated and naïve cohorts with baseline characteristics based on registry data.
RESULTS: For pre-treated patients, initiating ocrelizumab one line earlier reduced total costs by 24,594 € (€9,532 direct; €15,062 indirect) compared to less effective therapies. This strategy yielded a dominant ICER, providing 279,934 € in total savings per QALY gained, with higher QALY (+0.09) and a lower EDSS score (−0.34). First-line ocrelizumab use resulted in even greater direct cost savings, totalling €79,911 compared to other first-line comparators.
CONCLUSIONS: This study demonstrated that early initiation of ocrelizumab is dominant over comparator strategies and associated with lower disability, higher quality-of-life, and lower overall costs. These results support ocrelizumab as dominant from the healthcare-system and societal perspective and as a favourable treatment choice based on its robust safety and efficacy profile.
METHODS: The primary outcome was the modelled incremental cost-effectiveness ratio (ICER; €/quality-adjusted life-year [QALY] gained, threshold 25,000 €, discount rate 3%) over 10 years from the societal perspective. A Markov model with 3-moth cycles captured patient transitions between Expanded Disability Status Scale (EDSS) states, conversion to secondary progressive MS, relapses, adverse events, and death. Natural history and transition probabilities were derived from a published network meta-analysis. Treatment switching and discontinuation were also considered. Resource utilization and costs reflected Austrian clinical practice and local tariffs. Utility inputs were drawn from literature. Alternative treatment strategies were modelled in pre-treated and naïve cohorts with baseline characteristics based on registry data.
RESULTS: For pre-treated patients, initiating ocrelizumab one line earlier reduced total costs by 24,594 € (€9,532 direct; €15,062 indirect) compared to less effective therapies. This strategy yielded a dominant ICER, providing 279,934 € in total savings per QALY gained, with higher QALY (+0.09) and a lower EDSS score (−0.34). First-line ocrelizumab use resulted in even greater direct cost savings, totalling €79,911 compared to other first-line comparators.
CONCLUSIONS: This study demonstrated that early initiation of ocrelizumab is dominant over comparator strategies and associated with lower disability, higher quality-of-life, and lower overall costs. These results support ocrelizumab as dominant from the healthcare-system and societal perspective and as a favourable treatment choice based on its robust safety and efficacy profile.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE306
Topic
Economic Evaluation
Topic Subcategory
Value of Information
Disease
Biologics & Biosimilars, Neurological Disorders