[Cost-effectiveness analysis of peginterferon beta-1a in Italian relapsing remitting multiple sclerosis management]

Iannazzo, Sergio; Santoni, Laura; Saleri, Cecilia; Puma, Elisa; Vestri, Giulia; Giuliani, Luigi; Canonico, Pier Luigi; Centonze, Diego

doi:10.7175/fe.v17i2s.1230

Cited by 6 publications

(8 citation statements)

References 53 publications

(88 reference statements)

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“…In conclusione, la presente analisi ha stimato come l'introduzione di peginterferone beta1a, tra le alternative iniettabili disponibili per il trattamento di prima linea dei soggetti con SMRR in Italia, non comporti costi aggiuntivi ma anzi generi un risparmio per il SSN italiano. Questo risultato, unitamente con quanto emerso nell'analisi di costo-efficacia [49], mostra come peginterferone beta-1a sia un'opzione costo-efficace ed economicamente sostenibile nella prospettiva del SSN italiano e quindi rappresenti una valida opzione di trattamento per i pazienti affetti da SMRR in Italia.…”

Section: Analisi DI Sensibilitàunclassified

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

Iannazzo¹,

Santoni

Saleri

et al. 2016

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BACKGROUND: Peginterferon beta-1a, injected every two weeks, is the first approved pegylated interferon beta-1a for the treatment of relapsing remitting multiple sclerosis (RRMS). The objective of this analysis was to estimate the economic impact due to the introduction of peginterferon beta-1a in Italy.METHODS: This analysis was conducted with a three-year time horizon with the support of a simple decision-analytic model adopting the perspective of the Italian National Healthcare Service (NHS). Healthcare costs sustained by the Italian NHS to manage the RRMS population (drug treatment, monitoring, relapse management, adverse events management) were calculated over 3 years and compared in two scenarios: the base scenario where interferons-beta and glatiramer acetate (GA) are used to treat RRMS patients, and an alternative scenario where peginterferon beta-1a can also be used to treat RRMS patients. The target population was approximately 35,500, 37,500 and 39,500 patients at year 1, 2 and 3 respectively, based on the published literature and market data. The efficacy of treatments was simulated as a reduction of relapse rates and was derived from a Network Meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. A one-way sensitivity analysis was developed.RESULTS: According to current price and described assumptions, it was estimated that the introduction of peginterferon beta-1a would result in a decrease of total costs when compared with the base scenario. The cost in the base scenario was estimated to be € 321.5, € 339.7 and € 357.8 million in years 1, 2, and 3, respectively. In the alternative scenario, the same costs resulted in about € 321.1, € 338.6 and € 356.2 million, respectively. The cumulative budget impact over three years period was approximately a cost saving of € 3.1 million (about 0.3% saving).CONCLUSION: The adoption of peginterferon beta-1a for the treatment of RRMS would be viewed as economically sustainable by the Italian NHS.[Article in Italian]

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Section: Analisi DI Sensibilitàunclassified

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

Iannazzo¹,

Santoni

Saleri

et al. 2016

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“…As is the case in many different therapeutic areas, clinical progress in treating the disease has accompanied a rise in costs to purchase biologic products. In this light, economic evaluations are key elements for healthcare decision-making.In 2016 we published in this journal a cost-effectiveness analysis that compared subcutaneous peginterferon beta-1a 125 μg every 2 weeks (Plegridy ® ) to the other injectable DMTs used in first-line therapy of RRMS from both the perspective of the Italian National Healthcare Service (NHS) and of the Italian Society [5]. The comparators considered in the analysis were: interferon (IFN) beta-1a 30 μg (Avonex ® ), IFN beta-1a 22 μg (Rebif ® 22), IFN beta-1a 44 μg (Rebif ® 44), glatiramer acetate (GA, Copaxone ® ) 20 mg, IFN beta-1b 250 μg (Betaferon ® and Extavia ® ).…”

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confidence: 99%

“…While the design of the model and the choice of clinical parameters remains well aligned with the most recent cost-effectiveness studies published in the literature [6], some economic inputs of that analysis appear now outdated. The objective of the current work is thus to provide an update of the original analysis [5].…”

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confidence: 99%

“…update of the cost-effectiveness analysis of peginterferon beta-1a in italy The 2016 analysis [5] was conducted using a Markov model (Figure 1), reviewed and accepted by -among other agencies -the National Institute for Health and Care Excellence (NICE) in the UK [7]. The model simulates mortality, disease progression between EDSS levels, relapse frequency and transition to secondary progressive multiple sclerosis (SPMS), estimating the survival (life years; LYs), the survival adjusted for quality of life (quality-adjusted life years; QALYs), the overall costs, and the incremental cost per QALY gained (incremental cost effectiveness ratio; ICER).…”

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confidence: 99%

“…The model considers a time horizon of 50 years. Full details have been published previously in 2016 [5].…”

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Cost-Effectiveness Analysis of Peginterferon Beta-1a in the Treatment of Relapsing-Remitting Multiple Sclerosis in Italy: Results of an Updated Analysis

Centonze

Iannazzo

Santoni

et al. 2018

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background Multiple sclerosis (MS), a chronic inflammatory disease of the central nervous system, is causing a progressive disability that impacts patients' quality of life and societal costs [1]. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing form) or building up over time (progressive form) [2]. Between attacks, symptoms may disappear completely; however, permanent neurological problems often remain, especially as the disease advances [2]. In 85% of patients with MS the onset form is relapsing-remitting MS (RRMS) [3]. While MS is currently considered incurable, treatment has advanced significantly over the past several decades. Disease modifying therapies (DMTs) can reduce the frequency of clinical relapses and delay disability progression [4]. As is the case in many different therapeutic areas, clinical progress in treating the disease has accompanied a rise in costs to purchase biologic products. In this light, economic evaluations are key elements for healthcare decision-making.In 2016 we published in this journal a cost-effectiveness analysis that compared subcutaneous peginterferon beta-1a 125 μg every 2 weeks (Plegridy ® ) to the other injectable DMTs used in first-line therapy of RRMS from both the perspective of the Italian National Healthcare Service (NHS) and of the Italian Society [5]. The comparators considered in the analysis were: interferon (IFN) beta-1a 30 μg (Avonex ® ), IFN beta-1a 22 μg (Rebif ® 22), IFN beta-1a 44 μg (Rebif ® 44), glatiramer acetate (GA, Copaxone ® ) 20 mg, IFN beta-1b 250 μg (Betaferon ® and Extavia ® ). The 2016 analysis showed that peginterferon beta-1a was an alternative dominant or cost-effective vs IFNs and GA for the treatment of RRMS in Italy from the NHS and societal perspectives. While the design of the model and the choice of clinical parameters remains well aligned with the most recent cost-effectiveness studies published in the literature [6], some economic inputs of that analysis appear now outdated. The objective of the current work is thus to provide an update of the original analysis [5].

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Cost-utility analysis of teriflunomide in naïve vs. previously treated patients with relapsing–remitting multiple sclerosis in Italy

Lazzaro¹,

Bergamaschi²,

Zaffaroni

et al. 2022

Neurol Sci

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Background Multiple sclerosis (MS) accounts for 176 cases per 100,000 inhabitants (female/male ratio = 2:1) in Italy. For most of the patients (67%), the disease course is relapsing–remitting MS (RRMS). Objective To compare the costs and quality-adjusted life years (QALYs) of teriflunomide in RRMS naïve patients vs. RRMS patients previously treated (experienced) with other disease-modifying therapies in Italy. Methods A four health states Markov model-supported cost-utility analysis (CUA) covering a 7-year timespan through annual cycles was developed, following the healthcare sector and the societal viewpoints. Part of the parameters that populated the Markov model was obtained from a questionnaire administered to four primary Italian MS centres. Costs of healthcare and non-healthcare resources, expressed in euro (€) 2019, and QALYs were discounted at 3% real social discount rate. One-way, scenario and probabilistic sensitivity analyses tested the uncertainty of the baseline findings. Results Baseline CUA shows that teriflunomide in RRMS naïve patients is strongly dominant vs. experienced patients (healthcare sector perspective: − €1042.68 and + 0.480 QALYs; societal perspective: − €6782.81 and + 0.480 QALYs). Sensitivity analyses confirmed the robustness of the baseline results. Conclusion Teriflunomide in RRMS naïve vs. experienced patients is cost-effective and possibly strongly dominant from both the healthcare sector and the society viewpoints in Italy. Our findings need further confirmation from real-world studies.

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[Cost-effectiveness analysis of peginterferon beta-1a in Italian relapsing remitting multiple sclerosis management]

Cited by 6 publications

References 53 publications

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

Cost-Effectiveness Analysis of Peginterferon Beta-1a in the Treatment of Relapsing-Remitting Multiple Sclerosis in Italy: Results of an Updated Analysis

Cost-utility analysis of teriflunomide in naïve vs. previously treated patients with relapsing–remitting multiple sclerosis in Italy

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