The economic profile of peginterferon beta-1a in the treatment of relapsing-remitting multiple sclerosis in Italy

Abstract

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system with a very high economic impact. Peginterferon beta-1a is the first approved pegylated interferon beta-1a for the treatment of relapsing-remitting multiple sclerosis (RRMS). Its efficacy and safety were demonstrated in the placebo-controlled ADVANCE trial. A complete path to the assessment of a new health technology requires, in addition to a clinical evaluation, also an economic evaluation. In Italy, two economic evaluations were conducted and recently published. The objective of this article is focused on the two Italian economic analyses in order to describe the methods used, to summarize the main results, and to give a comprehensive picture of the pharmacoeconomic profile of peginterferon beta-1a in Italy in approved indication. The two analyses were conducted to evaluate such profile; the former was a cost-effectiveness analysis, the latter was a budget impact analysis:1) The cost-effectiveness analysis -developed through a lifetime Markov model -compared peginterferon beta-1a with injectable first-line treatments for RRMS in Italy from the perspective of the Italian National Healthcare Service (NHS) and from the societal perspective. Efficacy data were derived from a published Network Meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. From the Italian NHS perspective, peginterferon beta-1a was dominant in one case, while in all others its incremental cost-effectiveness ratio (ICER) was between €10,580/QALY and €22,023/QALY. From the societal perspective, peginterferon beta-1a was dominant versus every comparator.2) The budget impact analysis estimated -using a simple decision analytic model from the perspective of the Italian NHS -the financial impact due to the introduction of peginterferon beta-1a on the Italian drug market. The cumulative budget impact over 3 years was a cost saving of approximately €3.1 million. Based on the results of both analyses, the adoption of peginterferon beta-1a for the treatment of RRMS is not only clinically effective, but also economically efficient and financially sustainable from the Italian NHS perspective.

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

“…Studies tended to use utility data available in the literature, while some HTAs coupled the literature data with data from clinical trials. Thirteen studies in the UK [ 37 , 46 , 49 , 63 , 70 , 112 , 113 , 128 , 144 , 146 , 151 , 166 , 169 ], seven studies in the USA [ 40 , 41 , 71 – 73 , 114 , 137 ], and 11 studies in Europe [ 50 , 76 , 130 , 132 , 140 , 142 , 145 , 147 , 158 , 170 , 171 ] referred to published country-specific studies to derive utility inputs. Country-specific studies were used whenever available, while data from published studies from other countries were used in 12 studies [ 40 , 64 , 66 , 74 , 114 , 119 , 124 , 149 , 150 , 154 , 156 , 163 ] and five HTAs [ 98 – 100 , 102 , 161 ].…”

“…In total, 40 studies sourced data from natural history studies, 11 studies supplemented data from published natural history studies with data from clinical trials [51-53, 107, 139-145], and nine studies referred to clinical trials alone [67,75,116,130,132,[146][147][148][149]. Three studies extracted data from previously published economic evaluations [22,125,150].…”