title: Cost-effectiveness analysis of interferon beta-1b for the treatment of patients with a first clinical event suggestive of multiple sclerosis.
abstract: OBJECTIVE
  To assess, from a Swedish societal perspective, the cost effectiveness of interferon β-1b (IFNB-1b) after an initial clinical event suggestive of multiple sclerosis (MS) (ie, early treatment) compared with treatment after onset of clinically definite MS (CDMS) (ie, delayed treatment).
  
  
  METHODS
  A Markov model was developed, using patient level data from the BENEFIT trial and published literature, to estimate health outcomes and costs associated with IFNB-1b for hypothetical cohorts of patients after an initial clinical event suggestive of MS. Health states were defined by Kurtzke Expanded Disability Status Scale (EDSS) scores. Model outcomes included quality-adjusted life years (QALYs), total costs (including both direct and indirect costs), and incremental cost-effectiveness ratios. Sensitivity analyses were performed on key model parameters to assess the robustness of model results.
  
  
  RESULTS
  In the base case scenario, early IFNB-1b treatment was economically dominant (ie, less costly and more effective) versus delayed IFNB-1b treatment when QALYs were used as the effectiveness metric. Sensitivity analyses showed that the cost-effectiveness results were sensitive to model time horizon. Compared with the delayed treatment strategy, early treatment of MS was also associated with delayed EDSS progressions, prolonged time to CDMS diagnosis, and a reduction in frequency of relapse.
  
  
  CONCLUSIONS
  Early treatment with IFNB-1b for a first clinical event suggestive of MS was found to improve patient outcomes while controlling costs.
authors.affiliation: Formerly Abt Bio-Pharma Solutions Inc., Lexington, Massachusetts, USA. jcaloyer@prgs.edu
authors.forename: John P
authors.initials: JP
authors.lastname: Caloyeras
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Marianne
authors.initials: M
authors.lastname: Eriksson
authors.forename: Sten
authors.initials: S
authors.lastname: Fredrikson
authors.forename: Karola
authors.initials: K
authors.lastname: Beckmann
authors.forename: Volker
authors.initials: V
authors.lastname: Knappertz
authors.forename: Christoph
authors.initials: C
authors.lastname: Pohl
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Dhvani
authors.initials: D
authors.lastname: Shah
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Miller
authors.forename: Rupert
authors.initials: R
authors.lastname: Sandbrink
authors.forename: Vivian
authors.initials: V
authors.lastname: Lanius
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gondek
authors.forename: Mason W
authors.initials: MW
authors.lastname: Russell
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D017048:Health Care Costs; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008390:Markov Chains; D018803:Models, Economic; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D013548:Sweden; D013997:Time Factors
chemical_list: D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b; D016899:Interferon-beta