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Comparative Effectiveness and Cost-Effectiveness of Natalizumab and Fingolimod in Patients with Inadequate Response to Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis in the United Kingdom

Author

Listed:
  • Timothy Spelman

    (Monash University)

  • William L. Herring

    (RTI Health Solutions)

  • Yuanhui Zhang

    (RTI Health Solutions)

  • Michael Tempest

    (Biogen)

  • Isobel Pearson

    (RTI Health Solutions)

  • Ulrich Freudensprung

    (Medical, Biogen)

  • Carlos Acosta

    (Biogen International GmbH)

  • Thibaut Dort

    (Biogen International GmbH)

  • Robert Hyde

    (Medical, Biogen)

  • Eva Havrdova

    (General University Hospital and Charles University)

  • Dana Horakova

    (General University Hospital and Charles University)

  • Maria Trojano

    (University of Bari)

  • Giovanna Luca

    (University “G. d’Annunzio”)

  • Alessandra Lugaresi

    (IRCCS Istituto delle Scienze Neurologiche di Bologna
    Università di Bologna)

  • Guillermo Izquierdo

    (Hospital Universitario Virgen Macarena)

  • Pierre Grammond

    (Centre de Réadaptation Déficience Physique Chaudière-Appalache)

  • Pierre Duquette

    (Hôpital Notre Dame)

  • Raed Alroughani

    (Amiri Hospital)

  • Eugenio Pucci

    (ASUR Marche-AV3)

  • Franco Granella

    (University of Parma)

  • Jeannette Lechner-Scott

    (John Hunter Hospital)

  • Patrizia Sola

    (Azienda Ospedaliero Universitaria Policlinico/OCB, Neurology Unit)

  • Diana Ferraro

    (University of Modena and Reggio Emilia)

  • Francois Grand’Maison

    (Neuro Rive-Sud, Hôpital Charles LeMoyne)

  • Murat Terzi

    (Mayis University)

  • Csilla Rozsa

    (Jahn Ferenc Teaching Hospital)

  • Cavit Boz

    (Karadeniz Technical University)

  • Raymond Hupperts

    (Zuyderland Medical Center)

  • Vincent Pesch

    (Cliniques Universitaires Saint-Luc)

  • Celia Oreja-Guevara

    (Hospital ClínicoSan Carlos)

  • Anneke Walt

    (Monash University)

  • Vilija G. Jokubaitis

    (Monash University)

  • Tomas Kalincik

    (University of Melbourne
    Royal Melbourne Hospital)

  • Helmut Butzkueven

    (Monash University)

Abstract

Background Patients with highly active relapsing-remitting multiple sclerosis inadequately responding to first-line therapies (interferon-based therapies, glatiramer acetate, dimethyl fumarate, and teriflunomide, known collectively as “BRACETD”) often switch to natalizumab or fingolimod. Objective The aim was to estimate the comparative effectiveness of switching to natalizumab or fingolimod or within BRACETD using real-world data and to evaluate the cost-effectiveness of switching to natalizumab versus fingolimod using a United Kingdom (UK) third-party payer perspective. Methods Real-world data were obtained from MSBase for patients relapsing on BRACETD in the year before switching to natalizumab or fingolimod or within BRACETD. Three-way-multinomial-propensity-score–matched cohorts were identified, and comparisons between treatment groups were conducted for annualised relapse rate (ARR) and 6-month–confirmed disability worsening (CDW6M) and improvement (CDI6M). Results were applied in a cost-effectiveness model over a lifetime horizon using a published Markov structure with health states based on the Expanded Disability Status Scale. Other model parameters were obtained from the UK MS Survey 2015, published literature, and publicly available UK sources. Results The MSBase analysis found a significant reduction in ARR (rate ratio [RR] = 0.64; 95% confidence interval [CI] 0.57–0.72; p

Suggested Citation

  • Timothy Spelman & William L. Herring & Yuanhui Zhang & Michael Tempest & Isobel Pearson & Ulrich Freudensprung & Carlos Acosta & Thibaut Dort & Robert Hyde & Eva Havrdova & Dana Horakova & Maria Troja, 2022. "Comparative Effectiveness and Cost-Effectiveness of Natalizumab and Fingolimod in Patients with Inadequate Response to Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis in the Unit," PharmacoEconomics, Springer, vol. 40(3), pages 323-339, March.
    • Handle: RePEc:spr:pharme:v:40:y:2022:i:3:d:10.1007_s40273-021-01106-6
    DOI: 10.1007/s40273-021-01106-6
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    References listed on IDEAS

    as
    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    2. Bruce A. Craig & Peter P. Sendi, 2002. "Estimation of the transition matrix of a discrete‐time Markov chain," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 33-42, January.
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