Performance Improvement 2008. What is the Cost-effectiveness of Disease-Modifying Therapies for Treating Multiple Sclerosis?


Researchers developed a mathematical model to estimate the cost-effectiveness of interferon beta and glatiramer acetate compared to the best supportive care in the management of multiple sclerosis in the United States. Interferon beta and glatiramer acetate have demonstrated clinical efficacy in the treatment of relapsing-remitting and secondary progressive multiple sclerosis. With healthcare resources scarce, the value these therapies represent should be considered. Natural history data were drawn from a large longitudinal cohort study. Researchers synthesized the evidence on clinical effectiveness for these therapies using Bayesian techniques. Quality of life evidence was drawn from a study of patients with multiple sclerosis in Nova Scotia. Resource use and cost data were drawn from the Sonya Slifka database and associated literature.

When based upon placebo-controlled evidence only, the cost-effectiveness of interferon beta and glatiramer acetate was expected to be $104,000-$332,000 per quality-adjusted life year gained. When evidence from the head-to-head trials was incorporated into the analysis, the cost-effectiveness was expected to be less favorable. When patients were assumed to stop therapy upon disease progression the cost-effectiveness of disease-modifying therapy was notably improved. In conclusion: evidence surrounding the effectiveness and cost-effectiveness of interferon beta and glatiramer acetate was subject to considerable uncertainty. Further research is required to examine the long-term effectiveness of these therapies.

Report Title: A Cost Effectiveness Model of Disease Modifying Therapies for the Treatment of Multiple Sclerosis, Sponsor: CMS-ORDI, Office of Research, Development, and Information
Federal Contact: Penny Mohr, 410-786-6502
Sheffield University School of Health and Related Research
PIC ID: 8657

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