COST-CONSEQUENCE ANALYSIS OF HIGH-EFFICACY DISEASE-MODIFYING THERAPIES IN RELAPSING-REMITTING MULTIPLE SCLEROSIS PATIENTS WITH COMORBIDITY BURDEN IN SPAIN
Author(s)
Ángela Vidal-Jordana, MD1, Adrian Ares Luque, MD2, Ana Cristina Bandrés, PharmD3, Juan José Tamarit, MD4, Bleric Alcalá, MSc5, Heidi de los Santos Real, PhD5, Yeray Granado, PharmD5, Miriam Prades, PhD6, Susana Aceituno Mata, MSc, PhD6, María Luisa Martín, PharmD7, Mirian Álvarez-Payero, PharmD8.
1Neurology Department, Hospital de la Santa Creu i Sant Pau, IR Sant Pau, Barcelona, Spain, 2Neurology Service, Complejo Asistencial Universitario de León, León, Spain, 3Coordinación del Uso Racional del Medicamento de Aragón, Zaragoza, Spain, 4Internal Medicine Service, Consorcio Hospital General Universitario de Valencia, Valencia, Spain, 5Merck S.L.U., Madrid, Spain, an affiliate of Merck KGaA, Madrid, Spain, 6Antares Evidenze Health Consulting, Barcelona, Spain, 7Hospital Pharmacy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 8Hospital Pharmacy Service, Hospital de Valdeorras, Barco de Valdeorras, Ourense, Spain.
1Neurology Department, Hospital de la Santa Creu i Sant Pau, IR Sant Pau, Barcelona, Spain, 2Neurology Service, Complejo Asistencial Universitario de León, León, Spain, 3Coordinación del Uso Racional del Medicamento de Aragón, Zaragoza, Spain, 4Internal Medicine Service, Consorcio Hospital General Universitario de Valencia, Valencia, Spain, 5Merck S.L.U., Madrid, Spain, an affiliate of Merck KGaA, Madrid, Spain, 6Antares Evidenze Health Consulting, Barcelona, Spain, 7Hospital Pharmacy Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 8Hospital Pharmacy Service, Hospital de Valdeorras, Barco de Valdeorras, Ourense, Spain.
OBJECTIVES: Comorbidities in people with relapsing-remitting multiple sclerosis (pwRRMS) are associated with greater disability progression and relapse risk, increasing clinical and economic burden. This study assessed the cost-consequence of high-efficacy disease-modifying therapies in pwRRMS considering the presence of comorbidity burden (number of comorbidities) from the Spanish societal perspective.
METHODS: A 4-year prevalence-based model was developed to assess the cost-consequence of cladribine tablets (CladT), fingolimod, ponesimod, ozanimod, ocrelizumab, ofatumumab, and natalizumab. The presence of comorbidity burden (0, 1, ≥2) in pwRRMS was estimated from Spanish data. Disability progression and relapse risk were modelled based on the relationship between comorbidity burden and clinical activity. Direct (drug-cost, visits, tests, hospitalizations, informal care, and transportation), indirect (productivity losses), and intangible (quality-adjusted life year losses) costs related to disease progression and relapses were estimated (€, 2025). For each treatment the percentage of confirmed-disability-worsening-free (CDWF) and relapse-free (RF) patients, and the mean cost per-patient-year, were estimated considering efficacy and persistence. Cost-consequence results were expressed as the annual mean cost per CDWF patient and per RF patient. All inputs were sourced from official databases and literature and validated by a multidisciplinary expert panel. Sensitivity analyses were conducted.
RESULTS: A target pwRRMS population of 52,306 was estimated, of whom 24.7% and 39.8% had 1 and ≥ 2 comorbidities, respectively. The estimation of patients CDWF at 4 years ranged from 58.8% with ozanimod to 78.6% with ocrelizumab, while the proportion RF ranged from 62.5% with ponesimod to 77.1% with ocrelizumab. Mean cost per-patient-year varied between €34,372 (fingolimod) and €46,994 (ocrelizumab). The annual mean cost per CDWF patient ranged from €50,397 (CladT) to €64,140 (ozanimod), and from €52,770 (CladT) to €61,493 (ponesimod) per RF patient.
CONCLUSIONS: Considering the societal impact associated with comorbidity burden in pwRRMS, CladT demonstrated the lowest and the most favourable results from a cost-consequence perspective.
METHODS: A 4-year prevalence-based model was developed to assess the cost-consequence of cladribine tablets (CladT), fingolimod, ponesimod, ozanimod, ocrelizumab, ofatumumab, and natalizumab. The presence of comorbidity burden (0, 1, ≥2) in pwRRMS was estimated from Spanish data. Disability progression and relapse risk were modelled based on the relationship between comorbidity burden and clinical activity. Direct (drug-cost, visits, tests, hospitalizations, informal care, and transportation), indirect (productivity losses), and intangible (quality-adjusted life year losses) costs related to disease progression and relapses were estimated (€, 2025). For each treatment the percentage of confirmed-disability-worsening-free (CDWF) and relapse-free (RF) patients, and the mean cost per-patient-year, were estimated considering efficacy and persistence. Cost-consequence results were expressed as the annual mean cost per CDWF patient and per RF patient. All inputs were sourced from official databases and literature and validated by a multidisciplinary expert panel. Sensitivity analyses were conducted.
RESULTS: A target pwRRMS population of 52,306 was estimated, of whom 24.7% and 39.8% had 1 and ≥ 2 comorbidities, respectively. The estimation of patients CDWF at 4 years ranged from 58.8% with ozanimod to 78.6% with ocrelizumab, while the proportion RF ranged from 62.5% with ponesimod to 77.1% with ocrelizumab. Mean cost per-patient-year varied between €34,372 (fingolimod) and €46,994 (ocrelizumab). The annual mean cost per CDWF patient ranged from €50,397 (CladT) to €64,140 (ozanimod), and from €52,770 (CladT) to €61,493 (ponesimod) per RF patient.
CONCLUSIONS: Considering the societal impact associated with comorbidity burden in pwRRMS, CladT demonstrated the lowest and the most favourable results from a cost-consequence perspective.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE57
Topic
Economic Evaluation
Disease
Neurological Disorders