title: [The cost-effectiveness of interferon beta treatment in patients with a clinically isolated syndrome in Colombia].
abstract: BACKGROUND
  Approximately 85% of patients with multiple sclerosis have an initial demyelinating event. Treatment with interferon beta delays the progression of multiple sclerosis for nearly two years in patients with a clinically isolated syndrome. In Colombia, interferon is very expensive when compared to other countries.
  
  
  OBJECTIVE
  We sought to determine the cost-effectiveness of a two-year interferon beta treatment within Colombia in patients with a clinically isolated syndrome.
  
  
  METHODS
  Based on patient and society perspectives, a cost-effectiveness analysis was conducted using a decision tree. A variety of probabilities were defined after a systematic review of the available literature. The disease costs were calculated by reviewing medical charts at the Hospital San Ignacio University and surveys completed by multiple sclerosis patients. To control for uncertainty in these data, analysis of approximately one-thousand patients was performed using Monte Carlo methods.
  
  
  RESULTS
  The two-year treatment cost per patient exceeds Col$ 95,000,000 (US$ 50,000). Approximately 80 % of this cost corresponds to medications (US$ 40,500). The price of relapse and indirect costs totals Col$ 41,632,149 (US$ 21,744) and Col$ 11,656,389 (US$ 6,088), respectively. Treatment represents an increase of 0.06 quality-adjusted life years (QALY). The incremental cost-effectiveness ratio exceeds the threshold, regardless of the use of Monte Carlo methods for analysis.
  
  
  CONCLUSIONS
  Administering interferon beta over the course of two years to high-risk patients with a clinically isolated syndrome is not cost-effective within Colombia.
authors: Departamento de Neurociencias, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Luis Alfonso
authors: LA
authors: Zarco
authors: Departamento de Neurociencias, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Sonia Patricia
authors: SP
authors: Millán
authors: Unidad de Neumología, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Darío
authors: D
authors: Londoño
authors: Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Ludy
authors: L
authors: Parada
authors: Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Alejandra
authors: A
authors: Taborda
authors: Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
authors: Miguel Germán
authors: MG
authors: Borda
mesh_terms: D003105:Colombia; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D003711:Demyelinating Diseases / Q000150:complications / Q000188:drug therapy* / Q000191:economics*; D018450:Disease Progression; D006801:Humans; D016899:Interferon-beta / Q000191:economics* / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors
chemical_list: D016899:Interferon-beta