ECONOMIC EVALUATION OF A COMPREHENSIVE CARE AT HOME PROGRAM IN PATIENTS OF THE MEXICAN INSTITUTE OF SOCIAL SECURITY WITH MULTIPLE SCLEROSIS
Author(s)
Azamar Alonso A1, Mena Brito J2, Soto Molina H3
1National Institute of Public Health, Cuernavaca, Mexico, 2Mexican Institute of Social Security, Federal District, Mexico, 3Universidad Autónoma Metropolitana, Mexico City, Mexico
OBJECTIVES: Multiple Sclerosis (MS) disease treatment requires high adherence levels to maximize medicine effectiveness. It has been shown that comprehensive care at home programs in MS improve treatment adherence. In Mexico, average adherence levels for MS is less than 80%, therefore, the purpose of this study was to evaluate a comprehensive care at home program in patients of the Mexican Institute of Social Security with Multiple Sclerosis aimed to improve treatment adherence and to increase life expectancy. METHODS: The study design was a cost-effectiveness analysis from the governmental perspective. The costs for patient care were obtained from the Diagnosis-related groups that Mexican Institute of Social Security publishes and drugs costs were obtained also from the Institute. Costs were expressed in 2013 constant USD. A Markov model with sixty monthly cycles was developed. Based on the Expanded Disability Status Scale, we divided the model into six possible stages (4 EDSS stages, 2 for relapses according to EDSS stage) and death. We analyzed six different medicines (intramuscular interferon beta 1a, subcutaneous interferon beta 1a, subcutaneous interferon beta 1b, glatiramer acetate, Natalizumab and Fingolimod. Parameters were obtained from MS literature in Mexico. ICER per year life gained was estimated and discounted at 5% annual rate. RESULTS: The comprehensive care at home program increases life expectancy in a range of 6 to 12 months depending on the medicine we were analyzing. ICER is cost-effective ($ 556) in a five-year horizon. The program could increase adherence in more than 20 percentage points in the best scenario. CONCLUSIONS: The comprehensive care at home program could improve patient’s health and quality of life through increasing treatment adherence, therefore it could be considered for implementation beyond the Mexican institute of Social Security.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PHS57
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Neurological Disorders