Sawad AB, Seoane-Vazquez E, Rodriguez-Monguio R, Turkistani F. Cost-effectiveness of different strategies for treatment relapsing-remitting multiple sclerosis. J Comp Eff Res. 2017 . doi: 10.2217/cer-2016-0056. [Epub ahead of print]
AIM:To compare the cost-effectiveness of different disease-modifying therapies' strategies for treatment of relapsing-remitting multiple sclerosis.
METHODS:A Markov model was developed to assess the cost-effectiveness and incremental cost-effectiveness ratios for different strategies of using disease-modifying therapies from a US third-party payer perspective. All costs were converted to 2014 US$.
RESULTS: Over 20 years, the total costs per patient were estimated at US$161,136.60 for Strategy 1 (symptom management [SM] alone), US$551,650.66 for Strategy 2 (SM and IFN-β-1a), US$703,463.60 for Strategy 3 (SM and natalizumab) and US$670,985.24 for Strategy 4 (SM and alemtuzumab). The accumulated quality-adjusted life years were 10.49, 10.66, 10.69 and 10.71 for each of the four Strategies 1-4, respectively. The resulting incremental cost-effectiveness ratios were 2,297,141.53 comparing Strategy 2 to Strategy 1, and -1,623,918.00 comparing Strategy 4 to Strategy 3.
CONCLUSION: Strategy 1 was the cost-effective strategy for treatment of relapsing-remitting multiple sclerosis when compared with other strategies.
I am not sure that I can explain this one in terms of how cost-effectiveness was assessed but I think it says that in comparison to giving alemtuzumab, natalizumab, beta interferon or nothing (except symptom management) then nothing is the most-cost effective. Hardly surprising as the symptom control drugs cost "peanuts" and the other DMT cost "an arm and a leg".
This study panders to the "Lazy Neuro" approach recently renamed the "DreApproach (see comments from Yesterday). Apparantly you just rap "There....there, we'll get you a nice wheelchair...... Bruv!
I don't buy this, do nothing approach. It shows a real lack of ambition to make a change, We need to think about maintaining Brain Health for All.