A cost-effectiveness analysis of subcutaneous interferon beta-1a 44mcg 3-times a week vs no treatment for patients with clinically isolated syndrome in Sweden

Abstract

The risk of conversion from CIS to MS was extrapolated from 2-year trial data. Treatment benefit was assumed to persist over the model duration, although long-term data to support this are unavailable. Cost and QoL data from MS patients were assumed applicable to CIS patients.

Clinical effectiveness and cost-effectiveness of beta-interferon and glatiramer acetate for treating multiple sclerosis: systematic review and economic evaluation

“…On the basis of title and abstract, 435 records were excluded and the remaining 17 records were included for full-text screening. A further eight articles were excluded at the full-text stage, with the reasons for exclusion provided in Appendix 6, leaving nine studies [254][255][256][257][258][259][260][261][262] that included a decision-analytic model, which were used to estimate the cost-effectiveness of DMTs for treating people with CIS.…”

Cost-Effectiveness Modeling in Multiple Sclerosis: Playing Around with Non-Healthcare Costs?

“…All studies concluded in favor of the sponsored DMD, their results conflicting depending on the sponsor in the studies on RRMS. Unsurprisingly, time horizons and discount rates were the most influential variables in sensitivity analyses in four of the six studies [10][11][12]15] with a long-term horizon.…”

“…Five studies were based on Markov models with a long-term horizon and two on 'decision trees' [12,16], only one of them with a short-term horizon [16]. All studies used virtual cohorts of patients, only three referring to samples of clinical trials to define the virtual cohorts [10,11,16]. Extrapolation of short-term efficacy to long-term time horizons was performed in all studies but one [16].…”

“…1 The seven studies finally selected [10][11][12][13][14][15][16] came from only four countries (Germany, Italy, Spain, and Sweden) ( Table 1); three focused on clinically isolated syndrome (CIS) 2 (comparing DMD vs. 'do nothing' or early vs. delayed regimens of the same DMD) and the other four on RRMS patients (comparing the two IFNbs and GA). Three studies included a cost-utility analysis, two a cost-effectiveness analysis, and the others both.…”

“…Six studies sourced most costs from short-term, domestic, prevalence-based cost-of-illness (CoI) studies (all sponsored by DMD manufacturers), which all estimated a wide range of items including indirect and direct non-medical costs. To adapt this information and generate the data lacking to fully populate models, all studies relied on assumptions, three on anonymous experts [10,11,15], and two even on non-European [14] or unpublished data [16] to estimate relapse costs. Non-healthcare costs were a substantial proportion of total costs in all the six studies that adopted the societal perspective.…”