Multiple sclerosis in Italy: cost-of-illness study

Patti, Francesco; Amato, Maria Pia; Trojano, María; Solaro, Claudio; Pappalardo, A; Zipoli, Valentina; Portaccio, Emilio; Paolicelli, Damiano; Paolillo, Andrea; Mennini, F.S.; Marcellusi, Andrea; Ricci, Carmelo; Battaglia, Mario Alberto

doi:10.1007/s10072-011-0499-2

Cited by 33 publications

(41 citation statements)

References 29 publications

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“…Secondo le più recenti pubblicazioni, in Italia il costo medio per paziente-anno con SM, nella prospettiva della società, si aggira intorno a € 38.000, e varia da circa € 23.000 nei pazienti con lieve disabilità (Expanded Disability Status Scale, EDSS = 0-3), a circa € 44.000 nei pazienti con disabilità moderata (EDSS = 4-6.5), fino a oltre € 63.000 nei pazienti con disabilità grave (EDSS ≥ 7) [7]. La correlazione fra incremento della gravità della malattia e aumento dei costi è stata riportata da diversi studi italiani [1,2,4,[7][8][9][10][11] suggerendo l'opportunità di un investimento in trattamenti che siano in grado di rallentare la progressione di gravità della malattia migliorando anche la qualità di vita dei pazienti. I trattamenti per la SM hanno l'obiettivo di modificare il decorso clinico della malattia (Disease Modifying Therapies, DMT), e di ridurre o eliminare i sintomi o i segni delle ricadute.…”

Section: Farmeconomia Health Economics and Therapeutic Pathways 2016unclassified

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

Iannazzo¹,

Santoni²,

Saleri³

et al. 2016

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cronicità e la progressione della malattia con ricadute e disabilità crescente incidono sulla qualità di vita del paziente e sui costi per la società. L'esordio della malattia nella fase giovaneadulta coincide con il pieno della vita affetIntroduzIone L'organizzazione mondiale della sanità (OMS) ha definito la sclerosi multipla (SM) una delle malattie sociali maggiormente costose. L'esordio nella fase giovane-adulta, la AbstrActBACKGROUND: Peginterferon beta-1a is indicated in adult patients for the treatment of relapsing remitting multiple sclerosis (RRMS). The efficacy and safety of peginterferon beta-1a was demonstrated in the placebo-controlled ADVANCE trial. OBJECTIVE: The objective of this study was to assess the cost-effectiveness of peginterferon beta-1a as compared with injectable first-line treatments for RRMS in Italy. METHODS: The cost-effectiveness analysis was developed through a Markov model with lifetime simulation in the perspective of the Italian National Healthcare Service (NHS). It was added an alternative scenario to take into account the Italian societal perspective. Outcomes were measured in terms of life years (LYs), quality adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratio (ICER). The natural progression of the disease was informed by the published literature and previously published modelling exercises. The efficacy of treatments was simulated as reduction of disability progression (EDSS) and relapse rate. Efficacy data were derived from a published network meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. A 3.5% discount rate was applied to costs and outcomes. One-way and probabilistic sensitivity analyses were developed and cost-effectiveness acceptability curves generated. RESULTS: Peginterferon beta-1a was more effective than the comparators in terms of survival (19.94 vs.19.68-19.81 discounted LYs, respectively), and QALYs (9.07 vs. 8.06 and 8.55 discounted QALY, respectively). In the perspective of the Italian NHS, the ICER was € 11,111/QALY vs. interferon beta-1a 30 µg, € 12,604/QALY vs. interferon beta-1a 22 µg, € 10,580/QALY and € 16,702/QALY vs. interferon beta-1b 250 µg and € 22,023/QALY vs. glatiramer acetate 20 mg. Peginterferon beta-1a dominated interferon beta-1a 44 µg. In the societal perspective, peginterferon beta-1a was dominant due to being more effective and with a lower social cost compared to first-line injectable treatments (interferon beta -1a, interferon beta-1b, glatiramer acetate) for RRMS. The outcomes of the sensitivity analyses confirmed the trend of the base case results. CONCLUSIONS: Peginterferon beta-1a shows a favourable pharmaco-economic profile for the treatment of RRMS. Even if an official threshold for the cost-effectiveness does not exist in Italy, the ICER values obtained were far below the commonly accepted thresholds (30,000-50,000 €/per QALY gained). Keywords Cost-effectiveness; Peginterferon beta-1a; Multiple SclerosisAnalisi di costo-efficacia dell'utilizzo ...

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Section: Farmeconomia Health Economics and Therapeutic Pathways 2016unclassified

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

Iannazzo¹,

Santoni²,

Saleri³

et al. 2016

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“…This issue is becoming crucial, considering that the majority of MS patients required rehabilitation treatment [35] and that leads to increasing health costs [36]. To the best of our knowledge, only few studies were designed considering a comparison between two different settings of rehabilitation (outpatient versus inpatient).…”

Section: Discussionmentioning

confidence: 99%

Inpatient versus outpatient rehabilitation for multiple sclerosis patients: effects on disability and quality of life

Pappalardo¹,

D’Amico²,

Leone³

et al. 2016

Mult Scler Demyelinating Disord

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Background: The most suitable setting of rehabilitation for Persons with Multiple Sclerosis (PwMS) has not been identified so far because there is a general lacking of controlled studies. Aim of this study was to evaluate the treatment efficacy in terms of functional independence between two different settings. Methods: A randomized, wait-list controlled study was performed at the MS Center of the University of Catania, and Rehabilitation Center of the Hospital of Acireale, Italy. Inclusion criteria were: a) range of age 18-75, b) Expanded Disability Status Scale ≥4.0 and ≤8.0 c) self-reported worsening of standing or walking abilities in the last 6 months. The examining physician was blind to patient allocation program. The Functional Independence Measure (FIM), and the 36-Health Survey Questionnaire (SF-36) data were collected at T0 (baseline) and T1 (follow-up). Results: One-hundred forty-six patients were randomly assigned to three groups. Forty-nine PwMS were allocated in the outpatient treatment group (Group A), 49 patients in the inpatients treatment group (Group B) and 48 patients in the control waiting list (Group C). Both Group A and Group B showed a significant improvement in total FIM scores (p = 0.03, p = 0.008; respectively) at T1 compared to T0. No difference was found between Group A and B with regard to the FIM scores in the intergroup analysis. Group A showed significant improvement at T1 compared to T0 in all sub-items of SF-36 (p < 0.05), contrary to Group B. A significant difference in total FIM score between the three groups was found (p = 0.0003). The pairwise comparisons showed a significant difference between Group A vs Group C (p = 0.003) and Group B versus Group C (p = 0.001). Conclusions: Inpatients and oupatients rehabilitation approaches both showed efficacy in improving total FIM score. Outpatient rehabilitation setting seems to be more effective in improving patients QoL.

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“…A crucial aspect, during the last few years, has been that of adherence and compliance to pharmaceutical treatments as well as communication (58,59). COI studies are often carried out together with costutility analyses and Quality of Life Surveys (60,61). The focus of the literature is on new therapeutic options as well as the progressive forms of the disease; some research projects concerning palliative approaches to severe MS or communication in SP MS are being carried out (62).…”

Section: % Of Patientsmentioning

confidence: 99%

Living with Multiple Sclerosis in Europe: Pharmacological Treatments, Cost of Illness, and Health-Related Quality of Life Across Countries

Gitto

2017

Multiple Sclerosis: Perspectives in Treatment and Pathogenesis

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More than 700,000 people suffer from multiple sclerosis (MS) in Europe. This implies that more than 1 million people are affected by this disease through their role as caregivers and family members. Given its relevant impact, MS deserves consideration by epidemiologists, clinicians, psychologists, social scientists and other scholars. Such interdisciplinarity is stressed in the present contribution, which focuses on various aspects of socioeconomic burden. Starting from considerations about the epidemiology of the disease in Europe, as outlined by the MS Barometer, a comparative survey based on data collected by the national MS societies and launched in 2008, a brief literature review for each European country mentioned in the report was carried out with the following key terms: "multiple sclerosis," "cost of illness," and "health-related quality of life (HRQoL)." The consideration of the level of assistance provided, the access to rehabilitation centers, and the availability of pharmacological treatments, Drugs, Costs and Quality of Life for MS Patients in Europe 18especially innovative therapies, reveal how there are still huge differences across Europe. Literature contributions are mostly oriented toward HRQoL studies and the impact of new pharmacological treatments. There are less studies focusing on compliance: this may be the consequence of a higher awareness of the disease among the patients and a strengthened cooperation with the physicians. Some suggestions about foreseeable and desirable lines of research conclude the contribution.

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Multiple sclerosis in Italy: cost-of-illness study

Cited by 33 publications

References 29 publications

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

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

Inpatient versus outpatient rehabilitation for multiple sclerosis patients: effects on disability and quality of life

Living with Multiple Sclerosis in Europe: Pharmacological Treatments, Cost of Illness, and Health-Related Quality of Life Across Countries

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