title: Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis. Commentary: evaluating disease modifying treatments in multiple sclerosis.
abstract: OBJECTIVE
  To evaluate the cost effectiveness of four disease modifying treatments (interferon betas and glatiramer acetate) for relapsing remitting and secondary progressive multiple sclerosis in the United Kingdom.
  
  
  METHODS
  Modelling cost effectiveness.
  
  
  METHODS
  UK NHS.
  
  
  METHODS
  Patients with relapsing remitting multiple sclerosis and secondary progressive multiple sclerosis.
  
  
  METHODS
  Cost per quality adjusted life year gained.
  
  
  RESULTS
  The base case cost per quality adjusted life year gained by using any of the four treatments ranged from pound 42,000 (66,469 dollars; 61,630 euro) to pound 98,000 based on efficacy information in the public domain. Uncertainty analysis suggests that the probability of any of these treatments having a cost effectiveness better than pound 20,000 at 20 years is below 20%. The key determinants of cost effectiveness were the time horizon, the progression of patients after stopping treatment, differential discount rates, and the price of the treatments.
  
  
  CONCLUSIONS
  Cost effectiveness varied markedly between the interventions. Uncertainty around point estimates was substantial. This uncertainty could be reduced by conducting research on the true magnitude of the effect of these drugs, the progression of patients after stopping treatment, the costs of care, and the quality of life of the patients. Price was the key modifiable determinant of the cost effectiveness of these treatments.
authors.affiliation: School of Health and Related Research Rapid Reviews Group, School of Health and Related Research, University of Sheffield.
authors.forename: Jim
authors.initials: J
authors.lastname: Chilcott
authors.forename: Chris
authors.initials: C
authors.lastname: McCabe
authors.forename: Paul
authors.initials: P
authors.lastname: Tappenden
authors.forename: Anthony
authors.initials: A
authors.lastname: O'Hagan
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Cooper
authors.forename: Keith
authors.initials: K
authors.lastname: Abrams
authors.forename: Karl
authors.initials: K
authors.lastname: Claxton
authors.forename: David H
authors.initials: DH
authors.lastname: Miller
mesh_terms: D003362:Cost-Benefit Analysis; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000191:economics* / Q000627:therapeutic use; D016899:Interferon-beta / Q000191:economics* / Q000627:therapeutic use; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000191:economics; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000191:economics; D015999:Multivariate Analysis; D010455:Peptides / Q000191:economics* / Q000627:therapeutic use; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta