Cost-effectiveness of disease-modifying therapy for multiple sclerosis
- 26 July 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 77 (4), 355-363
- https://doi.org/10.1212/wnl.0b013e3182270402
Abstract
Objective: To evaluate the cost-effectiveness of disease-modifying therapies (DMTs) in the United States compared to basic supportive therapy without DMT for patients with relapsing multiple sclerosis (MS). Methods: Using data from a longitudinal MS survey, we generated 10-year disease progression paths for an MS cohort. We used first-order annual Markov models to estimate transitional probabilities. Costs associated with losses of employment were obtained from the Bureau of Labor Statistics. Medical costs were estimated using the Centers for Medicare and Medicaid Services reimbursement rates and other sources. Outcomes were measured as gains in quality-adjusted life-years (QALY) and relapse-free years. Monte Carlo simulations, resampling methods, and sensitivity analyses were conducted to evaluate model uncertainty. Results: Using DMT for 10 years resulted in modest health gains for all DMTs compared to treatment without DMT (0.082 QALY or Conclusion: Use of DMT in MS results in health gains that come at a very high cost.This publication has 33 references indexed in Scilit:
- The Multiple Sclerosis Risk Sharing Scheme Monitoring Study – early results and lessons for the futureBMC Neurology, 2009
- Disease-modifying agents in the Sonya Slifka Longitudinal Multiple Sclerosis StudyMultiple Sclerosis Journal, 2008
- Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questionsHealth Economics, 2004
- Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis * Commentary: Evaluating disease modifying treatments in multiple sclerosisBMJ, 2003
- Cost-utility of interferon β 1b in the treatment of patients with active relapsing-remitting or secondary progressive multiple sclerosisThe European Journal of Health Economics, 2003
- A cost-utility analysis of mitoxantrone hydrochloride and interferon beta-lb in the treatment of patients with secondary progressive or progressive relapsing multiple sclerosisClinical Therapeutics, 2003
- Long Term Treatment of Multiple Sclerosis with Interferon-?? May Be Cost EffectivePharmacoEconomics, 2000
- Disease steps in multiple sclerosis: a longitudinal study comparing Disease Steps and EDSS to evaluate disease progressionMultiple Sclerosis Journal, 1999
- Defining the clinical course of multiple sclerosisNeurology, 1996
- The MOS 36-ltem Short-Form Health Survey (SF-36)Medical Care, 1992