Cost-effectiveness analysis of glatiramer acetate in the treatment of relapsing-remitting multiple sclerosis

Convergence yet Continued Complexity: A Systematic Review and Critique of Health Economic Models of Relapsing-Remitting Multiple Sclerosis in the United Kingdom

“…Eleven articles from peer-reviewed journals met the inclusion criteria [14][15][16][17][18][19][20][21][22][23][24]. The one commissioned academic report to NICE [25], its addendum [26], and all five submissions to NICE [27][28][29][30][31] were also identified as relevant.…”

Cost-effectiveness of Four Immunomodulatory Therapies for Relapsing-Remitting Multiple Sclerosis: A Markov Model Based on Long-term Clinical Data

“…30,78 Overall, the majority of economic evaluations in MS, including the current analysis, resulted in ICERs well above the arbitrary and commonly referenced benchmark of $50,000 per QALY, even in the "best-case" scenarios used in sensitivity analyses. 30,[40][41][42][43][44][45][46]78,83 This was, in part, a reflection of (1) the chronic nature of the disease, (2) survival not being significantly affected by the disease, (3) the modest QALY benefits associated with immunomodulatory therapy in MS versus symptom management, and (4) the high drug acquisition costs of the immunomodulatory therapies. A review of the published costeffectiveness literature revealed a number of analyses of health care interventions that resulted in ICERs above the $50,000 per QALY benchmark, including $1.8 to $2.2 million per QALY as reported in the Prosser MS model 46 ; $91,000 per QALY for osteoarthritis or rheumatoid arthritis patients using diclofenac versus ibuprofen 84 ; $110,000 per QALY for patients using metformin in a diabetes prevention program 85 ; $200,000 per QALY for osteoarthritis or rheumatoid arthritis patients using diclofenac and a proton pump inhibitor versus celecoxib 84 ; $370,000 per QALY for women with irritable bowel syndrome using alosetron versus no treatment 86 ; and $56,000 to $840,000 per QALY for the use of high-dose erythropoietin versus normal dosages to maintain increased hemoglobin levels (e.g., 12-14 g/ dL).…”

“…A majority of the published CEA/CUA evaluations of immunomodulatory therapies for MS have been conducted from perspectives outside the United States. 30,[40][41][42][43][44][45] In a recent U.S.-based CUA evaluation, immunomodulatory therapy for the treatment of nonprimary, progressive MS (e.g., RRMS and SPMS) was compared with no treatment over a 10-year time horizon. 46 Cost-effectiveness results from this analysis, as well as previously published CUA evaluations, were considerably higher than the arbitrary and commonly referenced benchmark of $50,000 per quality-adjusted life-year (QALY).…”

Perspectives for Managed Care Organizations on the Burden of Multiple Sclerosis and the Cost-Benefits of Disease-Modifying Therapies

“…45,48 Numerous studies have assessed the cost per QALY of the approved DMTs for MS, aside from fingolimod (Table 4). 45,47,48,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] These studies arrived at widely different estimates, with costs per QALY varying from around $20,000 to over $1 million.…”

“…67 Consequently, a number of studies have investigated the cost of DMTs per each relapse avoided. 46,47,60,66,[68][69][70][71] Here, the focus is on comparative studies that examined differences in cost per relapse avoided among the various DMTs.…”