title: Economic evaluation of treating clinically isolated syndrome and subsequent multiple sclerosis with interferon beta-1b.
abstract: New therapeutic options have modified the natural history and health care costs of multiple sclerosis (MS). An epidemiological 25 years-long model-based cost-utility analysis was performed following the Italian National Health Service (INHS) and societal perspectives to compare costs and quality-adjusted life years of treatment with Interferon beta-1b (IFNB-1b) from diagnosis of clinically isolated syndrome (CIS) versus treating at subsequent conversion to clinically definite MS (CDMS). Among patients treated (untreated) with IFNB-1b from CIS diagnosis, 40,420 (43,700) converted to CDMS after 25 years; the estimated cumulative probability of converting to CDMS during the first 3 years was 72.90% (84.94%) (P < 0.0001). Early treatment with IFNB-1b is highly cost-effective for the INHS (incremental cost-effectiveness ratio: Euros 2,574.94) and dominant from the societal viewpoint. Sensitivity analyses confirmed the base case findings. Early treatment with IFNB-1b delays conversion to CDMS in CIS patients and might be a "good value for money" health care programme.
authors.affiliation: Studio di Economia Sanitaria, Via Stefanardo da Vimercate, 19, 20128 Milan, Italy. carlo.lazzaro@tin.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Lazzaro
authors.forename: Cosetta
authors.initials: C
authors.lastname: Bianchi
authors.forename: Lucia
authors.initials: L
authors.lastname: Peracino
authors.forename: Paola
authors.initials: P
authors.lastname: Zacchetti
authors.forename: Antonio
authors.initials: A
authors.lastname: Uccelli
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000379:methods; D018450:Disease Progression; D004334:Drug Administration Schedule; D042241:Early Diagnosis; D016021:Epidemiologic Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000191:economics* / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics* / Q000503:physiopathology; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data
chemical_list: D000068576:Interferon beta-1b; D016899:Interferon-beta