Peginterferon beta-1a versus other self-injectable disease-modifying therapies in the treatment of relapsing-remitting multiple sclerosis in Scotland: a cost-effectiveness analysis

Hernández, Luis; Guo, Shien; Toro-Díaz, Hector; Carroll, Stuart; Farooq, Syed Feisal Syed

doi:10.1080/13696998.2016.1247712

Cited by 17 publications

(33 citation statements)

References 43 publications

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“…45 Indirect comparisons have reported better clinical outcomes with peginterferon beta-1a than with SC or IM IFNβ-1a. 46,47 No evidence of disease activity (NEDA), increasingly considered the primary aim of MS treatment, is a composite of three measures of disease activity: no relapses, no disability progression, and no MRI activity (ie, new or enlarging T2 and Gd+ lesions). [48][49][50] In post hoc analyses of the EVIDENCE study, a head-to-head trial of SC and IM IFNβ-1a, more patients achieved clinical NEDA (defined as no relapses and no increase of ≥1.0 point in Expanded Disability Status Scale score from baseline sustained for 12 weeks) and MRI NEDA (defined as no new or newly enlarging T2 lesions) over 72 weeks with SC IFNβ-1a than with IM IFNβ-1a (clinical NEDA: 46.7% vs 33.3%; MRI NEDA: 48.6% vs 25.6%).…”

Section: Efficacy Of Interferon For Ms Treatmentmentioning

confidence: 99%

Interferons in the Treatment of Multiple Sclerosis

Filipi¹,

Jack²

2019

International Journal of MS Care

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Interferon (IFN) beta was the first disease-modifying therapy (DMT) available to treat multiple sclerosis (MS), providing patients with a treatment that resulted in reduced relapse rates and delays in the onset of disability. Four IFN beta drugs are currently approved to treat relapsing forms of MS: subcutaneous (SC) IFN beta-1b, SC IFN beta-1a, intramuscular IFN beta-1a, and, most recently, SC peginterferon beta-1a. Peginterferon beta-1a has an extended half-life and requires less frequent administration than with other available treatments (once every 2 weeks vs. every other day, 3 times per week, or weekly). Large, randomized controlled clinical trials have confirmed the efficacy of IFNs for treatment of relapsing MS. The most frequent adverse events experienced by patients receiving IFNs include injection site reactions (ISRs) and flu-like symptoms (FLS). Patient education and mitigation strategies are key to managing ISRs and FLS and supporting therapy adherence. With fewer injections needed, peginterferon beta-1a is associated with less frequent discomfort, which may translate to improved adherence, a major factor in treatment efficacy. Because the available IFN therapies differ in administration route and frequency of injection, switching among these therapies may be a viable option for patients who experience issues with tolerability. While there are now a number of DMTs available to treat relapsing MS, the efficacy and long-term safety profile of IFNs make them an important first-line option for treatment.

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Section: Efficacy Of Interferon For Ms Treatmentmentioning

confidence: 99%

Interferons in the Treatment of Multiple Sclerosis

Filipi¹,

Jack²

2019

International Journal of MS Care

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“…The most common publication referred to by the UK studies was that of Orme et al [ 172 ] ( n = 8) [ 46 , 49 , 70 , 112 , 113 , 128 , 144 , 166 ], while in the USA, the most common publication referred to was that of Prosser et al [ 173 ] ( n = 4) [ 71 – 73 , 137 ]. Another approach was to use data from clinical trials to supplement data from utility studies ( n = 9) [ 67 , 78 , 121 , 125 , 141 , 143 , 157 , 167 , 174 ].…”

Section: Resultsmentioning

confidence: 99%

“…'Others' ' refers to Asia (China, Iran, Saudi Arabia, Thailand), Brazil, Canada. DMT Disease-modifying therapy, RMS relapsing MS approach was to use data from clinical trials to supplement data from utility studies (n = 9) [67,78,121,125,141,143,157,167,174].…”

Section: Utility Valuesmentioning

confidence: 99%

How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

Wiyani¹,

Badgujar

Khurana³

et al. 2021

Neurol Ther

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Introduction: The introduction of diseasemodifying therapies (DMTs) for relapsing multiple sclerosis (RMS) over the last two decades has prompted the economic assessments of these treatments by reimbursement authorities. The aim of this systematic literature review was to evaluate the modeling approach and data sources used in economic evaluations of DMTs for RMS, identify differences and similarities, and explore how economic evaluation models have evolved over time. Methods: MEDLINEÒ, EmbaseÒ, and EBM Reviews databases were searched using OvidÒ Platform from database inception on 25 December 2019 and subsequently updated on 17 February 2021. In addition, health technology assessment agency websites, key conference proceedings, and gray literature from relevant

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“…Patients may experience difficulty in identifying their disease course, 80 and PPMS patients have on average a higher age of disease onset than RRMS and SPMS patients. 81 Although a number of model-based economic evaluations included populations with similar mean ages at onset based on study samples from pivotal DMD studies, ranging from 36 to 38 years, 29 , 32 , 82 – 85 some other studies included populations with mean ages of 29 40 or 33 32 years. Sensitivity analyses show that with lower ages of mean onset, shared decision making becomes more cost-effective, reducing the ICER with 17% (€3064) per QALY in comparison with the base case analysis.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands: A State Transition Model

et al. 2020

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Background Up to 31% of patients with relapsing-remitting multiple sclerosis (RRMS) discontinue treatment with disease-modifying drug (DMD) within the first year, and of the patients who do continue, about 40% are nonadherent. Shared decision making may decrease nonadherence and discontinuation rates, but evidence in the context of RRMS is limited. Shared decision making may, however, come at additional costs. This study aimed to explore the potential cost-effectiveness of shared decision making for RRMS in comparison with usual care, from a (limited) societal perspective over a lifetime. Methods An exploratory economic evaluation was conducted by adapting a previously developed state transition model that evaluates the cost-effectiveness of a range of DMDs for RRMS in comparison with the best supportive care. Three potential effects of shared decision making were explored: 1) a change in the initial DMD chosen, 2) a decrease in the patient’s discontinuation in using the DMD, and 3) an increase in adherence to the DMD. One-way and probabilistic sensitivity analyses of a scenario that combined the 3 effects were conducted. Results Each effect separately and the 3 effects combined resulted in higher quality-adjusted life years (QALYs) and costs due to the increased utilization of DMD. A decrease in discontinuation of DMDs influenced the incremental cost-effectiveness ratio (ICER) most. The combined scenario resulted in an ICER of €17,875 per QALY gained. The ICER was sensitive to changes in several parameters. Conclusion This study suggests that shared decision making for DMDs could potentially be cost-effective, especially if shared decision making would help to decrease treatment discontinuation. Our results, however, may depend on the assumed effects on treatment choice, persistence, and adherence, which are actually largely unknown.

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Peginterferon beta-1a versus other self-injectable disease-modifying therapies in the treatment of relapsing-remitting multiple sclerosis in Scotland: a cost-effectiveness analysis

Cited by 17 publications

References 43 publications

Interferons in the Treatment of Multiple Sclerosis

Interferons in the Treatment of Multiple Sclerosis

How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands: A State Transition Model

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