title: [Cost-effectiveness analysis of interferon beta-1b as treatment for patients with clinically isolated syndrome suggestive of multiple sclerosis in Spain].
abstract: BACKGROUND
  The BENEFIT study has demonstrated the benefits of early treatment with interferon beta 1b (IFNβ-1b). The objective of this study was to estimate the efficiency of early vs delayed IFNβ-1b treatment in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) in Spain.
  
  
  METHODS
  A Markov model reflecting the social perspective was developed with time horizons ranging from 2 years to lifetime. A cohort of 1000 patients with CIS, whose health status had been measured on the Expanded Disability Symptom Scale (EDSS), included patients who received early IFNβ-1b treatment and those who did not. Data from the BENEFIT study were used to model EDSS progression and transitions to MS. Costs were estimated from published literature. Patient utilities were derived from EQ-5D data and published data. Mortality was estimated using life tables and EDSS data. Costs (€ at 2013 rates) and outcomes were discounted at 3% per annum. A probabilistic sensitivity analysis was performed.
  
  
  RESULTS
  In the base case, both the incremental cost utility ratio (ICUR) and the incremental cost effectiveness ratio (ICER) of IFNβ-1b versus no treatment were dominant (more effective and less costly) from a social perspective. From the perspective of the Spanish Health System, the ICUR was € 40,702/QALY and the ICER was € 13/relapse avoided.
  
  
  CONCLUSIONS
  Early treatment with IFNβ-1b after a CIS versus delayed treatment is efficient from a social perspective, but it may not be efficient from the perspective of the NHS which does not take non health-related costs into account.
authors.affiliation: INNOVA Strategic Consulting, Barcelona, España. Electronic address: carme.pinyol@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Piñol
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D000068576:Interferon beta-1b / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics*; D019057:Quality-Adjusted Life Years; D012008:Recurrence; D013030:Spain
chemical_list: D000068576:Interferon beta-1b
keywords: Clinically isolated syndrome; Costes; Costs; Efficiency; Eficiencia; Esclerosis múltiple; Expanded Disability Syndrome Scale; Interferon beta 1b; Interferón beta 1b; Multiple sclerosis; Síndrome desmielinizante aislado