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

Abstract

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recent cost-effectiveness studies published in the literature [6], some economic inputs of that analysis appear now outdated.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].