COST-EFFECTIVENESS ANALYSIS OF ALEMTUZUMAB IN COMPARISON WITH NATALIZUMAB, INTRAMUSCULAR INTERFERON BETA-1A, SUBCUTANEOUS INTERFERON BETA-1B, AND FINGOLIMOD FOR THE TREATMENT OF RELAPSING-REMITTING MULTIPLE SCLEROSIS IN IRAN
Author(s)
Taheri S1, Yousefi N1, Sahraian MA2, Mehralian G1
1Shahid Beheshti University of Medical Sciences, School of Pharmacy, Tehran, Iran (Islamic Republic of), 2MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of)
OBJECTIVES: In the era of representing new medicines for the treatment of Multiple sclerosis, a highly debilitating immune mediated disorder, evaluating the incremental cost-effectiveness of medicines are necessary for allocating health care resources in an efficient manner. Therefore, this study was aimed to to assess the cost-effectiveness of Alemtuzumab (ALM) in comparison with Natalizumab (NTZ), intramuscular interferon beta-1a (IM-IFN), subcutaneous interferon beta-1b (SC-IFN), and fingolimod (FNG) for the treatment of relapsing-remitting multiple sclerosis (RRMS) from Iranian healthcare perspective. METHODS: A multistage Markov model was developed using the Microsoft Excel to assess the incremental cost-effectiveness ratio over a 5-year time horizon in a cohort of 1000 patients with RRMS. The London Ontario dataset, published clinical trials, and long term follow-up studies was used to estimate the transition probability matrix. The costs were measured as US Dollars based on local tariffs and the effectiveness were measured as Quality-adjusted life years (QALYs). Finally, incremental cost-effectiveness ratios (ICERs) calculated as cost per QALYs gained. Sensitivity analysis were conducted to show the robustness of the model over the uncertainty of key parameters. RESULTS: Results showed that Compared with NTZ, ALM was less expensive and more effective and has been chosen as a dominant strategy (ALM: $101,868 and 2.44 QALYs; NTZ: $103,437 and 2.33 QALYs). However, compared with IM-IFN, SC-IFN, and FNG, ALM had an ICER of $50,482, $49,164, and $39,253 per QALYs gained, respectively (IM-IFN: $87,733 and 2.16 QALYs; SC-IFN: $88,102 and 2.16 QALYs; FNG: $96,765 and 2.31 QALYs). The sensitivity analysis further indicated the robustness of the model. CONCLUSIONS: ALM is dominantly cost-effective treatment strategy compared with NTZ in the treatment of RRMS patients. However, compared with IM-IFN, SC-IFN, and FNG, ALM would be cost-effective at the willingness to pay threshold of about ≥$50,000, ≥$49,000, and ≥$39,000 per QALYs gained from an Iranian healthcare perspective.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PND32
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Neurological Disorders