Cost-utility of First-line Disease-modifying Treatments for Relapsing–Remitting Multiple Sclerosis

Abstract

The results were sensitive only to large changes in analysis perspective or MTC. Based on the analyses, teriflunomide was cost-effective versus BSC or DMF with the common threshold values, was dominant versus other first-line RRMS treatments, and provided the greatest impact on investment. Teriflunomide is potentially the most cost-effective option among first-line treatments of RRMS in Finland.

Cost Assessment Modelling of Treatments for Highly Active Relapsing Multiple Sclerosis

“…The CAM approach was developed for easy and safe estimation of costs over time. To ensure the coverage of important features, PICOSTEPS principle [16,[21][22][23] was applied in the CAM dashboard.…”

“…PICOSTEPS (Patients-Intervention-Comparators-Outcomes-Setting-Time-Effects-Perspective-Sensitivity analysis) is a framework for reporting health economic studies. It covers the essential parts of health economic evaluations in their order of importance [16,21,23]; (Table 1). PICOSTEPS has been used in multiple Finnish health economic studies and in a Current Care guideline [16,21,23].…”

“…Highly active disease patients are defined by clinical or imaging features according to the Finnish treatment guidelines and reimbursement criteria [9,24,25]. Seventy-two percent of patients were women in the model input [16]. Patients were assumed to stay alive until the end of follow-up (4 years).…”

“…The estimated annual economic burden of MS in Finland using a bottom-up approach of costing was €46,994 per patient on average and increasing from €10,835 to €109,901 in parallel with advancing disability [15]. Based on a modelled economic evaluation of RRMS patients who have initiated a DMD, effective and reasonably priced DMDs may compensate for various RRMS-related costs in a 15-year time horizon [16]. The impact of MS medication costs on overall healthcare systems has been assessed by per-member per-period costs, where MS represents the fourth most expensive therapy class following inflammatory conditions, diabetes and cancer [17].…”

“…The impact of MS medication costs on overall healthcare systems has been assessed by per-member per-period costs, where MS represents the fourth most expensive therapy class following inflammatory conditions, diabetes and cancer [17]. In Finland, the estimated proportion of total costs attributable to DMDs is high over 1-year [15] and moderately high (11-18%, depending on DMD) over 15-year [16] time horizons among RRMS patients who have initiated DMD and were valid for a publicly reimbursed DMD.…”