Tuesday, 3 March 2015

Cheaper Cardboard makes you happier


Najafi B, Ghaderi H, Jafari M, Najafi S, Ahmad Kiadaliri A. Cost Effectiveness Analysis of Avonex and CinnoVex in Relapsing Remitting MS. Glob J Health Sci. 2014 Oct 9;7(2):38659. doi: 10.5539/gjhs.v7n2p139.

INTRODUCTION:Multiple sclerosis is a chronic and degenerative neurological disease characterized by loss of myelin sheath of some neurons in brain and spinal cord. It is associated with high economic burden due to premature deaths and high occurrence of disabilities. The aim of the current study was to determine cost effectiveness of two major products of interferon 1a in patients with relapsing-remitting multiple sclerosis.
METHOD AND MATERIALS: Altogether, 140 patients who have consumed Avonex and CinnoVex in Relapsing Remitting MS for at least two years were randomly selected (70 patients in each group). Health-related quality of life (HRQoL) was assessed using the adopted MSQoL-54 instrument. Costs were measured and valued from Ministry of Health and Medical Education (MOHME) perspective. Two-way sensitivity analysis was used to check robustness of the results.
RESULTS: Patients in CinnoVex group reported significantly higher scores in both physical (69.5 vs. 50.9, P<0.001) and mental (63.3 vs. 56.6, P=0.03) aspects of HRQoL than Avonex group. On the other hand, annual cost of CinnoVex and Avonex were 2410 US$ and 4515US$ per patient, respectively (P<0.001).
CONCLUSIONS: The results showed that CinnoVex was dominant option over the study period. It is suggested that results of the current study should be considered in allocating resources to MS treatments in Iran. Of course, our findings should be interpreted with caution duo to short term horizon and lack of HRQoL scores at baseline (before the intervention)
CinnoVex became the first biogeneric clone of interferon-beta to be used for treatment of MS, when it was approved by the Iranian Food and Drug Administration. Based on quality of Life scores MSers using CinnoVex appeared to be happier than people using Avonex for the USA. Is this because people were not using American product or the fact that it was 20 times cheaper. Is it twenty times better...I doubt it, but they are not all created equal.

If you have a limited budget do you want to fleeced by the the more expensive alternative? 

Many people prefer to get their drugs from the brand they trust. This is a product of Marketing. Just as you can pay for the packaging of brand leaders or supermarket generics, which are 10 times cheaper, even when beta intererons are made in essentially the same place...people can be convinced to pay more for the cardboard.