OBJECTIVES

Primary-Progredient Multiple Sclerosis (PPMS) is an indication in which, until recently, only the best supportive therapy (BSC) was used. Drugs used in highly active remitting multiple sclerosis (HARMS) are high-cost therapy and their effectiveness differ. Ocrelizumab is a new drug from the group of monoclonal antibodies to the CD20 B-lymphocyte receptor and its use can lead to changes in the budget for the treatment of PPMS and HARMS. The aim of the study was to determine the budget impact of the inclusion in the public funding of the use of ocrelizumab in both indications in Russia.

METHODS

The populations of PPMS and HARMS were determined on the basis of literature data (both is 10% of the total population of MS patients). The analysis point of view (federal and regional), the time horizon (1, 2, 5 years), and analysis scenarios were set basing on MS experts' opinion. For PPMS, it was assumed that patients would receive BSC (existing scenario) or ocrelizumab (new scenario). For HARMS, it was assumed that patients would receive alemtuzumab or natalizumab (existing scenarios 1 and 2) or ocrelizumab (new scenario).

RESULTS

The use of ocrelizumab instead of BSC in PPMS increases costs/year by 73 864 873.84 euro. The use of ocrelizumab instead of natalizumab and alemtuzumab in HARMS reduces costs in the first year by 35 134 031,85 and 174 442 131,17 euro, respectively.

CONCLUSIONS

The use of ocrelizumab instead of BSC in PPMS causes additional budget costs, and in HARMS instead of natalizumab and alemtuzumab, with reduces them. The use of ocrelizumab in both indications could lead to providing PPMS patients with the first effective drug therapy in their indication and at the expense of financial savings associated with the use of ocrelizumab instead of alemtuzumab in HARMS and would not lead to additional costs of MS therapy.