Monday, 11 February 2013

The economics of treating MS

#MSBlog: What is the difference between Extavia and Betaseron? Their price?

Epub: Brandes, et al. Implications of Real-world Adherence on Cost-effectiveness Analysis in Multiple Sclerosis. J Med Econ. 2013 Feb.

Objectives: Adherence to medication is essential for optimal outcomes, especially for chronic diseases such as multiple sclerosis (MS). Studies in MS indicate that lower adherence is associated with an increased risk of relapse, hospitalization or emergency room (ER) visits, and higher medical costs. A previous investigation assessed the cost per relapse avoided for patients with MS receiving first-line disease modifying therapies (DMTs); however, the model assumed 100% adherence.

Methods: Because real-world utilization patterns influence the actual effectiveness of medications, this analysis assessed the impact of real-world adherence from a US commercial payer perspective, using updated costs.

Results: As was seen in the original study, in this revised model, fingolimod was associated with the lowest cost per relapse avoided ($90,566), followed by SC IFN β-1b (Extavia: $127,024), SC IFN β-1b (Betaseron: $137,492), SC IFN β-1a ($144,016), glatiramer acetate ($160,314), and IM IFN β-1a ($312,629). The model inputs that had the greatest impact on the results were adherence-adjusted relative relapse rate reduction (RRR) of fingolimod, the wholesale acquisition costs of fingolimod, and the average number of relapses in untreated MSers.

Limitations: The estimates of DMT adherence are from a single claims database study of a large national pharmacy benefit manager that only measured adherence, not actual relapses, and the model does not incorporate manufacturer discounts and rebates, which are not publicly available. 

Conclusion: These results suggest that economic analyses of MS therapies should incorporate real-world adherence rates where available, rather than relying exclusively on trial-based efficacy estimates when considering the economic value of treatment alternatives, and that highly efficacious therapies with low adherence may yield real-world efficacy that is substantially lower than that observed in closely monitored clinical trials.



"Isn't it amazing that a few letters can make such a difference in price; $10,000 to be precise! Did you know that Extavia and Betaseron are the same product, but in different packaging?"

1 comment:

  1. very depressing,if the costs are as close to what yu are saying, the NHS and equivalent systems world-wide are going to tell us, either pay-up or tigh astone to one end of a rope, the other end round the MS sufferer and tell us to jump in at the deap end. that said, when people apply to courts to be allowed to die with dignity, but they need aide to do so, the courts rule against them, sentencing them to a life that is not a life, knowing, as we all do that there is no cure, and if one promising one comes out it'll take up to 15 years to begin circulating, which gets the MS'er in btha age bracket where they reckon it's not worth giving it. vicious ircle. know you tryng your best, can't be rushed but when you hear the othe end of the story of how much the pharmeceutical companies get out of their medications -admitedly they put in a lot but expect to get more out - makes you wonder to their intentions. the man caught in the middle is you doing the research and all that entails. do't think we are ungratefull, but just look at the sale of the company that got Tysabri going and how much they sold it for and to who - it's own owners !!!????? clear example.

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