OBJECTIVES

Ocrelizumab is a high-efficacy disease modifying therapy (DMT) for patients with relapsing remitting multiple sclerosis (RRMS). To assess the socioeconomic value of ocrelizumab in RRMS compared with teriflunomide, dimethyl fumarate, and cladribine in Canada.

METHODS

A Markov-state model based on one-point spaced Expanded Disability Status Scale (EDSS) states (0–9) was used to estimate costs associated with disease progression. EDSS at baseline and transition probabilities were derived from the OPERA trials and MSBase natural history study, respectively. Treatment effect on delaying disability progression was modeled through hazard ratios for time to 12-week confirmed disability progression, derived from a network meta-analysis. Societal benefits included savings in direct healthcare and non-healthcare costs, and indirect costs (including informal care and productivity loss). Drug costs were excluded to focus on treatment benefits. Resource use and cost inputs at 2019 prices were derived from published studies in the multiple sclerosis space or from national statistics databases. Data on RRMS prevalence and proportion of patients treated with DMTs in Canada were obtained by triangulating Canadian epidemiologic data, Roche RRMS market share forecast and real world data from the Ocrevus patient support program.

RESULTS

The socioeconomic value of ocrelizumab compared with teriflunomide, dimethyl fumarate, and cladribine in Canada is estimated to be CAD$216.6 million, $125.5 million and $17.9 million over five years, respectively. These cost savings are mostly driven by reduction of healthcare resource utilization and community services ($153.6 million, $82.2 million, and $10.9 million), productivity loss ($35.3 million, $24.3 million, and $3.9 million), and informal care ($17.9 million, $12.2 million, and $2.0 million); values compared with teriflunomide, dimethyl fumarate, and cladribine, respectively.

CONCLUSIONS

Ocrelizumab for RRMS offers substantial socioeconomic benefits compared with relevant first- and second-line DMTs in Canada.