CLINICAL EFFECTIVENESS AND HEALTH OUTCOMES OF DISEASE MODIFYING TREATMENT (DMT) THAT DELAYS DISABILITY PROGRESSION IN RELAPSING/REMITTING-ONSET MULTIPLE SCLEROSIS- NOVA SCOTIA ‘REAL WORLD' EVIDENCE
Author(s)
Murray G Brown, PhD, Research Associate1, Sarah Kirby, MD, Dr1, John D Fisk, PhD, Dr1, Ingrida S Sketris, DPharm, Dr2, Jeffrey Hoch, PhD, Dr3, Virender Bhan, Md, Dr1, T Jock Murray, MD, Dr1, Chris Skedgel, MDE, Health Economist1, Donna MacKinnon-Cameron, MSc, Statistician1, Karen Stadnyk, MSc, Research Associate11Capital Health Nova Scotia, Halifax, NS, Canada; 2 Dalhousie University, Halifax, NS, Canada; 3 University of Toronto, Toronto, ON, Canada
OBJECTIVES: Estimate clinical effectiveness and health outcomes of short-term DMT that delays disability progression in relapsing/remitting-onset definite MS (RR-onset MS). Nova Scotia (NS) natural history data (1979-March 2004) and MS Special Therapies Program (STP) data (July 1998 - March 2004) are analyzed. The STP provides universal full-cost coverage of Avonex®, Betaseron®, Copaxone®, Rebif6® and Rebif12® for RR-onset MS, as insurer of last-resort. METHODS: Extended Disability Status Scale (EDSS) natural history (NH) increase per year, increase avoided per DMT-year, and DMT effect size relative to NH are estimated using well-validated data (9,238 clinic visits by 1435 persons with RR-onset MS) from the Dalhousie MS Research Unit (DMSRU) clinic. Models estimate EDSS paths from years-since-onset (yso) given ‘conventional care' or DMT. NH data is from never-DMT-plus-ever-DMT persons or ever-DMT persons. Analysis is stratified by ‘final' class [relapsing/remitting (RRMS) or secondary progressive (SPMS)] and six severity-yso data-cells (EDSS
Conference/Value in Health Info
2006-05, ISPOR 2006, Philadelphia, PA
Value in Health, Vol. 9, No.3 (May/June 2006)
Code
PNL1
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Neurological Disorders