OBJECTIVES: Multiple sclerosis (MS) is a chronic, progressive neurological disease characterized by localized inflammation, demyelination, and axonal degeneration. Relapsing-remitting (RR)MS is the most common form with 85% of cases diagnosed. Ponesimod is an oral disease modifying therapy (DMT) for the treatment of RRMS that was recently reimbursed Italy as second line treatment (2L). This analysis assesses the budget impact of switching Italian patients currently receiving any DMT to ponesimod.

METHODS: The model estimated the financial impact to the National and Regional Healthcare Service (NHS) over 3 years following treatment with ponesimod. Eligible patient population was identified using Italian-specific epidemiological data. Market share switching rates for various DMTs came from an Italian survey of 260 MS treating neurologists. Unit costs of DMTs, adverse event (AE) management and cost of relapses were collected from published literature and institutional Italian data. Natural history of relapse rates for RRMS and rate ratios for each DMT, applied to the average natural history relapse rates, came from published literature.

RESULTS: Approximately 135, 762 and 1,302 patients are expected to switch to ponesimod in Italy over 3 years, respectively. The 3-year budget for ponesimod was estimated of € 30.1 M, of which € 29.8 M were acquisition costs of drug. The budget for ponesimod was offset by cost savings from drug acquisition, drug administration, AE management compared to 2L monoclonal antibodies (mAbs) resulting in overall net savings of € 4.5 M.

CONCLUSIONS: The introduction of ponesimod for the treatment of RRMS resulted in estimated net savings of € 4.5 M to the Italian NHS over 3-years that was largely driven by cost savings for drug acquisition, drug administration, and AE management versus 2L mAbs.