A Health-Economic Evaluation of Disease-Modifying Drugs for the Treatment of Relapsing-Remitting Multiple Sclerosis From the German Societal Perspective

被引:14
作者
Nuijten, Mark [1 ]
Mittendorf, Thomas [2 ,3 ]
机构
[1] Ars Accessus Medica, Amsterdam, Netherlands
[2] Herescon Gmbh, Hlth Econ Res & Consulting, Hannover, Germany
[3] Leibniz Univ Hannover, Ctr Hlth Econ, Hannover, Germany
关键词
multiple sclerosis; cost-effectiveness; Germany; DOUBLE-BLIND; INTERFERON-BETA; NATURAL-HISTORY; COST-EFFECTIVENESS; MULTICENTER; PROGRESSION;
D O I
10.1016/j.clinthera.2010.03.019
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Objective: This analysis compared the cost-effectiveness of interferon beta-1a (IFN beta-1a) 44 mu g SC with that of other available first-line treatments for relapsing-remitting multiple sclerosis (RRMS) from the German societal perspective in 2008. Methods: A decision-analytic model was used to estimate the cost-effectiveness of IFN beta-1a 44 mu g SC given 3 times weekly compared with that of IFN beta-1a 30 mu g IM given once weekly, IFN beta-1b 8 mIU given every other day, and glatiramer acetate 20 mg SC given once daily. Data sources included the published literature, clinical trials, German price/tariff lists, and national population statistics. The time horizon of the model was 4 years, which was the maximum duration of follow-up in published clinical trials. Results: The cost-effectiveness (cost per relapse avoided) of IFN beta-1a 44 mu g SC compared with no active treatment was (sic)51,250, which compared favorably with that of IFN beta-1a 30 mu g IM ((sic)133,770), glatiramer acetate ((sic)71,416), and IFN beta-1b ((sic)54,475). When the cost of disease progression was excluded, the cost per relapse avoided remained favorable for IFN beta-1a 44 mu g SC ((sic)54,292) compared with the other options ((sic)143,186, (sic)72,809, and (sic)56,816, respectively). Indirect comparison of each available treatment option with the next best alternative indicated that the incremental cost-effectiveness of IFN beta-1a 44 mu g SC ((sic)23,449) was consistent with accepted thresholds. Sensitivity analyses in which the discount rate, frequency of relapse and disease progression, costs of relapse and disease progression, and adherence were varied did not affect the relative outcomes. Conclusion: In this analysis from the German societal perspective, IFN beta-1a 44 mu g SC had favorable overall cost-effectiveness versus no active treatment compared with other available disease-modifying drugs for the treatment of RRMS. (Clin Ther. 2010;32:717-728) (C) 2010 Excerpta Medica Inc.
引用
收藏
页码:717 / 728
页数:12
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