Cost-effectiveness analysis of interferon beta in multiple sclerosis: a Markov process analysis.
OBJECTIVE
The objective of this study was to examine the cost-effectiveness of preventive treatment with interferon beta (IFNB) versus no preventive treatment in patients with multiple sclerosis.


METHODS
The setting for this study was the United Kingdom. A lifetime Markov process model was constructed to model the average quality-adjusted life years (QALYs) and the costs of both treatment strategies. Data for the construction of the model came from published literature, including large multicenter randomized clinical trials in relapsing-remitting and secondary progressive multiple sclerosis. Costs were obtained from published sources.


RESULTS
The results of the baseline analysis from the National Health Service (NHS) perspective showed that the use of interferon beta as preventive treatment for MS increased the total average discounted cost from 51,214 Pounds to 221,436 Pounds per patient. The undiscounted effectiveness increased from 24.9 QALYs to 28.2 QALYs, resulting in an incremental cost-effectiveness ratio of 51,582 Pounds per QALY. Sensitivity analyses showed the robustness of this model for other interferons.


CONCLUSIONS
The study showed that preventive treatment with interferon beta in patients with multiple sclerosis may not be fully justified from a health-economic perspective, although interferon beta is associated with an improved effectiveness compared with no preventive treatment.
Nuijten
Mark J C
MJ
MEDTAP International, Dorpsstraat 75, 1546 LG Jisp, Amsterdam, Netherlands. nuijten@medtap.nl
Hutton
John
J
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors
D000276:Adjuvants, Immunologic; D016899:Interferon-beta