COST-EFFECTIVENESS ANALYSIS OF PEGINTERFERON BETA-1A VS. FIRST-LINE INJECTABLE DISEASE-MODIFYING THERAPIES FOR THE TREATMENT OF RELAPSING-REMITTING MULTIPLE SCLEROSIS IN SPAIN
Author(s)
Ruiz L1, Toro-Diaz H2, Cele C3, Hernandez L3, Harrington A4
1Biogen, Madrid, Spain, 2Evidera, Lexington, MA, Switzerland, 3Evidera, Lexington, MA, USA, 4Biogen International GmbH, Zug, Switzerland
OBJECTIVES: This study assesses cost-effectiveness of subcutaneous (SC) peginterferon beta-1a 125 mcg SC every two weeks vs. other first-line injectable disease-modifying therapies (DMTs) such as glatiramer acetate 40mg SC daily, interferon beta-1a 30mcg intramuscular (IM) once a week, interferon beta-1a 44mcg SC three times a week, and interferon beta-1b 250mcg SC every other day, in the treatment of relapsing remitting multiple sclerosis (RRMS) from the payer perspective in Spain, over a 30-year time horizon METHODS: A Markov cohort economic model was developed for this analysis. Patients began in RRMS, distributed across Expanded Disability Status Scale (EDSS) score states. Every one year cycle, patients could experience a relapse, die, transition to lower or higher EDSS states, and/or progress to secondary-progressive MS (SPMS). The model predicts the occurrence of these transitions, translates the time spent in each health state into quality-adjusted life-years (QALYs), and assigns associated costs. Comparative efficacy of each DMT vs. placebo was obtained from a network meta-analysis. Administration and monitoring costs were sourced from public databases and literature. Drug costs included mandatory discounts. Clinical and economic outcomes were discounted at 3% per year RESULTS: Over 30 years, peginterferon beta-1a was dominant (i.e., more effective and less costly) vs. all comparators. Peginterferon beta-1a was associated with incremental QALY gains of 0.47, 0.20, 0.06, and 0.62 compared with glatiramer acetate, interferon beta-1a IM, interferon beta-1a SC, and interferon beta-1b, respectively. Peginterferon beta-1a was associated with cost-savings of €16,203, €9,220, €13,393 and €23,792, compared with glatiramer acetate, interferon beta-1a IM, interferon beta-1a SC, and interferon beta-1b SC, respectively. Results were robust across a wide range of deterministic and probabilistic sensitivity analyses. CONCLUSIONS: This analysis suggests that long-term treatment with peginterferon beta-1a improves clinical outcomes at reduced costs compared with other first-line injectable DMTs, and, considering efficiency criteria, is a valuable option for treating patients with RRMS.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PND35
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Neurological Disorders