title: Cost-effectiveness of injectable disease-modifying therapies for the treatment of relapsing forms of multiple sclerosis in Spain.
abstract: OBJECTIVE
  To compare the cost-effectiveness of injectable disease-modifying therapies (DMTs) for the first-line treatment of relapsing-remitting multiple sclerosis (RRMS) in Spain.
  
  
  METHODS
  A Markov model was developed to estimate the cost-effectiveness of intramuscular interferon beta-1a (IM IFNβ-1a), subcutaneous interferon beta-1a (SC IFNβ-1a), interferon beta-1b (IFNβ-1b) and glatiramer acetate (GA) relative to best supportive care in a hypothetical cohort of 1,000 RRMS patients in Spain. The model was developed from a societal perspective with a time horizon of 30 years. Natural history and clinical trial data were used to model relapse rates and disease progression. Cost and utility data were obtained from a published survey of multiple sclerosis patients in Spain. The primary outcome measure was cost per quality-adjusted life year (QALY) gained. Univariate and probabilistic sensitivity analyses were performed.
  
  
  RESULTS
  Compared to best supportive care, the base case cost-effectiveness was <euro>168,629 per QALY gained for IM IFNβ-1a, <euro>231,853 per QALY gained for IFNβ-1b, <euro>295,638 per QALY gained for SC IFNβ-1a, and <euro>318,818 per QALY gained for GA. Results were most sensitive to changes in DMT cost, utility values and treatment effect.
  
  
  CONCLUSIONS
  In our cost-effectiveness analysis of first-line injectable DMTs in Spain, we found IM IFNβ-1a to be more cost-effective than SC IFNβ-1a, IFNβ-1b or GA. Sensitivity analyses confirmed the robustness of these results.
authors.affiliation: Avalere Health, 1350 Connecticut Ave, NW Suite 900, Washington, DC, 20036, USA, cdembek@avalerehealth.net.
authors.forename: Carole
authors.initials: C
authors.lastname: Dembek
authors.forename: Leigh Ann
authors.initials: LA
authors.lastname: White
authors.forename: Jayson
authors.initials: J
authors.lastname: Quach
authors.forename: Andrea
authors.initials: A
authors.lastname: Szkurhan
authors.forename: Nazia
authors.initials: N
authors.lastname: Rashid
authors.forename: M R
authors.initials: MR
authors.lastname: Blasco
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000191:economics*; D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007267:Injections; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b; D016899:Interferon-beta; D000068556:Interferon beta-1a