OBJECTIVES: Relapsing-remitting multiple sclerosis (RRMS) is a chronic autoimmune disorder characterized by periods of symptom flare-ups, followed by periods of disease remission. The aim of this study was to develop an economic model to determine the cost-consequence of cladribine tablets (CladT) compared to other disease modifying therapies (DMTs) used for treating highly-active RRMS (HA-RRMS) from a UK National Health Service (NHS) perspective.

METHODS: A de novo decision analytic framework was developed to model i) switching between index treatments and subsequent treatments and ii) progression from responding to relapsing phases of HA-RRMS. Outcomes and costs were quantified from a UK NHS perspective for up to 8 years. Rates of relapse and treatment switching were based on treatment-specific data from the real-world GLIMPSE study. SAE rates were estimated using trial data. Drug acquisition costs were sourced from the British National Formulary. Costs for administration and monitoring, relapse and SAE were derived from published sources.

RESULTS: The model showed that over 8 years, patients with HA-RRMS spent 23.8-24.0 and 27.6-38.3 additional patient months of index treatment time as responders (i.e. not relapsing) when using CladT vs oral and infused DMTs, respectively. Over 8 years, CladT costs were £90,551 per patient vs £125,812 to £171,541 for other oral DMTs and £165,995 to £195,613 for infused DMTs. Use of CladT over this period amounted to a reduction in costs per patient vs oral and infused DMTs of 28.0%-47.2% and 45.5-53.7%, respectively. The cost savings per additional year of index treatment in the responding phase was £17,799 to £40,565 for orals and £23,622 to £40,499 for infused DMTs.

CONCLUSIONS: CladT may offer substantial cost-savings and improved treatment outcomes compared to oral and infused DMTs. When results are extrapolated to the UK HA-RRMS population, substantial savings for the NHS could be expected.