Healthcare Resource Utilization and Costs for Extended Interval Dosing of Natalizumab in Relapsing Remitting Multiple Sclerosis
Author(s)
Moccia M1, Loperto I1, Santoni L2, Masera S2, Carotenuto A1, Triassi M1, Brescia Morra V1, Palladino R1
1Federico II University of Naples, Napoli, NA, Italy, 2Biogen, Milan, Italy
OBJECTIVES Natalizumab is approved to be administered every 4 weeks (standard interval dosing, SID) in relapsing remitting multiple sclerosis (RRMS). Recently, extended interval dosing (EID) has been used by some physicians to reduce progressive multifocal leukoencephalopathy (PML) risk. However, the extent to which EID can impact on healthcare resources and costs remains unknown METHODS In this population-based study conducted in the Campania Region of Italy, from 2015 to 2017, we included RRMS patients exposed to Natalizumab for at least 18 months. Healthcare data from hospital discharges, drug prescriptions, outpatient consultations and costs were derived from Regional Administrative Databases. EID was defined as ≤15 infusions in the last 18 months; SID was defined as >15 infusions in the last 18 months. We used logistic regression, Poisson regression and linear regression models, as appropriate, to study the association between SID/EID and healthcare resources utilization and costs. In the absence of clinical data, the covariates were age, sex, year of treatment start (<2015, 2015 or 2016), and Charlson comorbidity index, which weights chronic comorbidities to define an overall risk RESULTS Out of 426 patients treated with Natalizumab, we included 208 patients. 157 patients were on SID (75.5%; age=36.5±10.8 years; female=68.1%) with mean±SD of 31.3±2.4 days infusion interval and 29.9±2.4 months of treatment, whilst 51 were on EID (24.5%; age=33.7±11.1 years; female=72.5%) with 43.1±4.8 days infusion interval and 33.5±3.2 months of treatment. Compared with SID, Natalizumab EID was associated with lower MS outpatient visits (p=0.01) and related costs (p=0.03), and lower natalizumab costs (p<0.01), without changes in other MS and non-MS-related healthcare resource utilization and costs CONCLUSIONS Analyzing Regional Administrative Databases in Campania Region, Natalizumab EID seems to be associated with 23% reduced direct treatment costs, without additional healthcare burden for Italian National Healthcare Service. Limitations include the inability to adjust for clinical measures and potential selection bias
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PDG80
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Comparative Effectiveness or Efficacy, Health & Insurance Records Systems
Disease
Drugs, Neurological Disorders