title: Cost analysis of glatiramer acetate versus interferon-β for relapsing-remitting multiple sclerosis in patients with spasticity: the Escala study.
abstract: OBJECTIVE
  The Escala Study evidenced that the administration of glatiramer acetate for relapsing-remitting multiple sclerosis improved the spasticity of patients previously treated with interferon-β. However, whether such an improvement was translated into cost savings remained unclear. We therefore conducted a cost analysis of glatiramer acetate versus interferon-β in these patients with multiple sclerosis and spasticity.
  
  
  METHODS
  This cost analysis encompassed data from the observational Escala Study, which included patients with relapsing-remitting multiple sclerosis and spasticity whose treatment had been switched from interferon-β to glatiramer acetate. Costs prior to starting glatiramer acetate (interferon-β period) were compared to the subsequent six months on glatiramer acetate (glatiramer acetate period). The analysis was carried out following the recommendations for conducting pharmacoeconomic studies and from the Spanish National Health System perspective. Costs associated with multiple sclerosis treatment, spasticity treatment and relapse management were expressed in 2014 euros (€); a 7.5 % discount was applied-when needed-as stipulated in Spanish law.
  
  
  RESULTS
  The management of relapsing-remitting multiple sclerosis, spasticity and relapses accounted for a 6-month cost per patient of 7,078.02€ when using interferon-β and 4,671.31€ when using glatiramer acetate. Switching from interferon-β to glatiramer acetate therefore represented a cost saving of 2,406.72€ per patient in favour of glatiramer acetate, which resulted from savings in treatment costs, relapse management and spasticity treatment of 1,890.02€, 430.48€ and 86.21€, respectively. The ratio of the costs during interferon-β was 1.5 times the costs during glatiramer acetate; thus, a fixed budget of 5,000,000€ would enable 1,070 patients to be treated with glatiramer acetate and only 706 patients with interferon-β.
  
  
  CONCLUSIONS
  The treatment of relapsing-remitting multiple sclerosis with glatiramer acetate entailed cost savings when compared to interferon-β in patients with spasticity, which not only resulted from its lower costs of therapy and relapse management but also from its favourable effect on reducing spasticity. Thus, glatiramer acetate may be regarded as a more efficient alternative than interferon-β from the perspective of the Spanish National Health System.
authors.affiliation: Medical Department, TEVA Pharmaceutical, Calle de Anabel Segura, 11, 28108, Madrid, Spain. rainel.sanchez@tevaes.com.
authors.forename: Rainel
authors.initials: R
authors.lastname: Sánchez-de la Rosa
authors.affiliation: Market Access & Regulatory Department, TEVA Pharmaceutical, Calle de Anabel Segura, 11, 28108, Madrid, Spain. Laura.GarciaBujalance@tevaes.com.
authors.forename: Laura
authors.initials: L
authors.lastname: García-Bujalance
authors.affiliation: Neurology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Carretera Madrid-Cartagena, S/N, 30120, El Palmar, Spain. pmecal@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Meca-Lallana
keywords: Cost analysis; Glatiramer acetate; Interferon-β; Relapsing-remitting multiple sclerosis; Spasticity