OBJECTIVES: Fampridine is the only approved symptomatic drug to improve multiple sclerosis (MS) related walking disability globally. This study aims to evaluate the cost-effectiveness of adding fampridine to best supportive care (BSC) versus BSC alone for the improvement of walking ability in adult MS patients with Expanded Disability Status Scale (EDSS) score 4-7 in China.

METHODS: A cost-utility analysis was conducted based on a hybrid decision tree and Markov model from both the societal and healthcare system perspective in China. The modelled treatment effect and utility data were derived from the phase III trial (ENHANCE) of fampridine. The BSC was consisted of other supportive drugs, outpatient visits, examination and lab tests, hospitalization and rehabilitation. The fampridine plus BSC strategy considered the drug cost and adverse event management cost of fampridine additionally. Costs of walking aids and productivity loss were also included in the societal perspective. Unit costs and utilization of healthcare resource were obtained from published source or physicians’ interview. Both quality-adjusted life years (QALY) and costs were discounted at a rate of 5%, and a half-cycle correction was applied. Uncertainty was assessed by one-way and probabilistic sensitivity analyses.

RESULTS: Over a 10-year time horizon, adding fampridine to BSC led to an incremental QALY gain of 0.15 and lower total costs from both perspectives. The addition of fampridine reduced the cost of healthcare resource use, especially costs of rehabilitation, other supportive drugs and outpatient visits. In addition, fampridine plus BSC strategy presented lower costs of walking aids and productivity loss of patients & caregivers from the societal perspective. Sensitivity analyses confirmed the robustness of the results.

CONCLUSIONS: Compared to BSC alone, fampridine plus BSC is considered as an economically dominant strategy (better effectiveness and lower costs) for adult patients with MS with EDSS 4-7 in China.