OBJECTIVES: Multiple sclerosis (MS) is the most frequent cause of non-traumatic neurologic disability in young adults. In Italy, there are approximately 114,000 affected patients and >3,400 new cases annually. Around 85% of patients present with relapsing-remitting forms of MS (RRMS) at onset. Oral teriflunomide (TF) once daily and dimethyl fumarate (DMF) twice daily are disease-modifying therapies indicated for the treatment of RRMS. The aim of this research was to assess costs associated with TF compared with DMF for the treatment of RRMS in Italy.

METHODS: In number needed to treat (NNT) analyses and recent Italian, international, and US-based real-world studies (e.g., the Teri-RADAR study), the effectiveness/efficacy of TF and DMF was comparable; therefore, a cost-minimization analysis was conducted. The cost of treatment was determined and evaluated from a payer’s perspective (€, 2018), considering 5-year and 10-year time durations. Treatment costs were retrieved from published sources and included drug use, administration, monitoring and adverse events. Sensitivity analyses were conducted, altering drug prices (−10%, −20%).

RESULTS: The estimated annual cost/patient with TF and DMF was € 10.999,06 and € 12.217,61, respectively. Compared with DMF, treatment with TF could save € 4.257,29 and € 5.850,78 over a 5-year and 10-year time period, respectively. Savings are driven mainly by differences in drug acquisition cost and, to a lesser extent, monitoring costs. Under discounted drug price scenarios, TF remains cost-saving vs DMF.

CONCLUSIONS: Evidence from different sources suggests comparable effects for TF and DMF on clinical and MRI outcomes. This economic analysis suggests that treatment with TF is associated with lower costs compared with DMF in the management of RRMS in Italy. For decision makers, treatment with TF may represent an efficient use of resources for patients with RRMS.