OBJECTIVES: Ofatumumab is a high-efficacy disease-modifying therapy (DMT) with a favourable benefit-risk profile recently approved in Greece for the treatment of relapsing multiple sclerosis (RMS). The purpose of this study was to evaluate the cost-effectiveness of ofatumumab vs currently available DMTs (interferon b-1a and -1b, dimethyl fumarate, teriflunomide, glatiramer acetate, ocrelizumab, natalizumab, and fingolimod) for RMS patients from the Greek payer perspective.

METHODS: A cohort Markov model based on disease progression through Expanded Disability Status Scale health states, with annual cycles and lifetime horizon was developed. This model was centered on disability progression and relapses. Baseline characteristics were sourced from the ASCLEPIOS I & II clinical trials. Natural history disability progression and relapse rate are referenced from the British Columbia dataset and published literature. The inputs for the treatment-adjusted model, i.e., the hazard ratio for time to 6-month confirmed disability progression and relapse rate were sourced from a published network meta-analysis. Utilities, costs of therapies, other direct medical and non-medical costs, and relapse and adverse event management costs were obtained from published literature and publicly available sources.

RESULTS: Over a lifetime horizon, ofatumumab was predicted to yield more quality-adjusted life-years (QALYs) vs other DMTs (11.37 vs 10.17-11.21). Ofatumumab dominates ocrelizumab and fingolimod (i.e., cost-saving and more effective). Furthermore, ofatumumab was found to be cost-effective compared to other DMTs (natalizumab: 21,337 €/QALY; teriflunomide: 24,434 €/QALY; interferon b-1a: 26,756 €/QALY; glatiramer acetate: 30,788 €/QALY; interferon b-1a: 32,622 €/QALY, and dimethyl fumarate: 32,659 €/QALY) at the willingness-to-pay threshold of WHO-recommended three times gross domestic product per capita of Greece (i.e., 48,807 €/QALY).

CONCLUSIONS: From a Greek payer perspective, ofatumumab was estimated to be cost-effective compared to the other DMTs for the treatment of RMS patients.