Cost-effectiveness of glatiramer acetate and interferon beta-1a for relapsing-remitting multiple sclerosis, based on the CombiRx study

Abstract

GA was shown to be a cost-effective treatment option for the prevention of relapses in Spanish patients diagnosed with RRMS. When GA in monotherapy is compared with INF in monotherapy and IFN+GA combined, it may be concluded that the first is the dominant strategy.

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, 1168 records were excluded and the remaining 225 records were included for full-text screening. A further 213 articles were excluded at the full-text stage (see Appendix 7 for a list of excluded studies with reasons), leaving 10 studies 154,[264][265][266][267][268][269][270][271][272] that included a decision-analytic model used to estimate the cost-effectiveness of DMTs for treating people with RRMS. …”

“…Darbà et al 268 Darbà et al 268 undertook a cost-effectiveness analysis and compared the costs and consequences of treating RRMS with GA, IM IFN-β-1b and combination therapy with GA and IM IFN-β-1b. The analysis used a Spanish payer perspective, future costs and outcomes were discounted and costs were adjusted to 2013 euros.…”

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

“…Three studies included a cost-utility analysis, two a cost-effectiveness analysis, and the others both. Only one study adopted exclusively the third-party payer's perspective [14]; the others took the societal viewpoint (together with the third-party payer's perspective in two studies). 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].…”

“…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.…”