OBJECTIVES

: Multiple sclerosis (MS) treatment is very expensive. However, indirect costs associated with disease progression raise financial burden. In developing countries, this often leads to patients being unable to receive treatment on time, that has aggravated the situation more.

Purpose of the study was to conduct cost-effectiveness analysis in different stages of MS therapy according to national clinical guidelines and drug policy.

METHODS

We compared the cost-effectiveness of multiple sclerosis disease modifying therapeutics (MSDMT) within the groups both first line and second line drugs for relapsing-remitting MS (RMS) and relapses of progressive forms of MS (PMS). In Central Asia Interferon beta, Glatimer acetate are presented as injectable medications; Teriflunomide, Fingolimod and Dymethyl fumorate as oral medication, Ocrelizumab and Natalizumab as infused medication.

RESULTS

: We analyzed the expenditures for first line therapy RMS. The cost of one year use of Glatiramer acetate was 10000$ and it was more cost-effective than other drugs, while the effectiveness in slowing the progression of disability in them wasn’t very varied. Total costs of first and second line therapy RMS didn’t differ, but last showed higher efficiency. Annual course treatment with Fingolimod has been more expensive (about 30000$), Natalizumab showed less safety, so Ocrelizumab should be preferred as second line, since the indicators of cost-effectiveness of it was lower. Ocrelizumab also showed the cost-effectiveness benefit for PMS, it had been valued at 17500$ per year.

CONCLUSIONS

: The Glatiramer acetate showed benefit as first line drug for RMS, the second line medicine should be Ocrelizumab. If the first line medication is ineffective, the second line treatment must be prescribed immediately due to the cost of the annual course of treatment differs insignificantly. Ocrelizumab is the best choice for PMS.