A health-economic evaluation of disease-modifying drugs for the treatment of relapsing-remitting multiple sclerosis from the German societal perspective.
OBJECTIVE
This analysis compared the cost-effectiveness of interferon beta-1a (IFNbeta-1a) 44 microg 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 IFNbeta-1a 44 microg SC given 3 times weekly compared with that of IFNbeta-la 30 microg IM given once weekly, IFNbeta-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 IFNbeta-la 44 microg SC compared with no active treatment was euro51,250, which compared favorably with that of IFNbeta-la 30 microg IM (euro133,770), glatiramer acetate (euro71,416), and IFNbeta-1b (euro54,475). When the cost of disease progression was excluded, the cost per relapse avoided remained favorable for IFNbeta-1a 44 microg SC (euro54,292) compared with the other options (euro143,186, euro72,809, and euro56,816, respectively). Indirect comparison of each available treatment option with the next best alternative indicated that the incremental cost-effectiveness of IFNbeta-la 44 microg SC (euro23,449) 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.


CONCLUSIONS
In this analysis from the German societal perspective, IFNbeta-la 44 microg SC had favorable overall cost-effectiveness versus no active treatment compared with other available disease-modifying drugs for the treatment of RRMS.
Nuijten
Mark
M
Ars Accessus Medica, Amsterdam, the Netherlands. nuijten@bmg.eur.nl
Mittendorf
Thomas
T
D000276:Adjuvants, Immunologic / Q000191:economics* / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005858:Germany; D000068717:Glatiramer Acetate; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000191:economics* / Q000627:therapeutic use; D018803:Models, Economic; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy / Q000191:economics*; D010455:Peptides / Q000191:economics* / Q000627:therapeutic use; D015203:Reproducibility of Results; D013997:Time Factors
D000276:Adjuvants, Immunologic; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a