Cost-effectiveness Analysis of Ocrelizumab for the Treatment of Relapsing and Primary Progressive Multiple Sclerosis in Portugal

Martins, P.A.F.; Vandewalle, Björn; Félix, Jorge Vinícius Cestari; Capela, Carlos; Cerqueira, João José; Salgado, A; Ferreira, Diana G.; Monteiro, Isabel

doi:10.1007/s41669-022-00381-z

Cited by 5 publications

(11 citation statements)

References 52 publications

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“…Our study confirmed that ocrelizumab has lower direct treatment costs than those of other highly active DMTs [2], thus further reinforcing its cost-saving value or, at least, cost effectiveness [14]. This is partly due to the overall costs of ocrelizumab but also relates to the modalities of utilization, including in MS patients in the early stages of the disease and with a higher comorbidity burden, where other DMTs do not perform equally well.…”

Section: Discussionsupporting

confidence: 77%

“…The remaining patients (32.7%) received ocrelizumab following other high-efficacy DMTs due to a combination of tolerability and efficacy is-sues [12]. As such, the increasing utilization of ocrelizumab possibly reflects unmet needs in MS, especially in the case of progressive aspects [13,14]. This prescription pattern is in line with that found in studies conducted within the same time frame in the US [15] and Australia [16].…”

Section: Discussionsupporting

confidence: 71%

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Utilization of Ocrelizumab within Different Treatment Strategies for Multiple Sclerosis: A 5-Year Population-Based Study

Moccia,

Affinito,

Marrazzo

et al. 2024

Neurology International

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Background: We aim to provide up-to-date real-world evidence on the persistence, adherence, healthcare resource utilization, and costs of multiple sclerosis (MS) by comparing ocrelizumab to other disease-modifying treatments (DMTs) and within different DMT sequences. Methods: We included 3371 people with MS who first received or switched DMT prescriptions from January 2018 to December 2022; they were identified through hospital discharge records, drug prescriptions, and exemption codes from the Campania Region (South Italy). We calculated persistence (time from the first prescription to discontinuation or switching to another DMT), adherence (proportion of days covered (PDC)), DMT costs, and MS hospital admissions and related costs. Results: The most frequently prescribed DMT was dimethyl fumarate (n = 815; age 38.90 ± 11.91 years; 69.5% females), followed by ocrelizumab (n = 682; age 46.46 ± 11.29 years; 56.3%); 28.8% of the patients treated with ocrelizumab were naïve to DMTs. Using ocrelizumab as a statistical reference, the risk of discontinuation was higher for other highly active (HR = 6.32; 95%CI = 3.16, 12.63; p < 0.01) and low-/medium-efficacy DMTs (HR = 10.10; 95%CI = 5.10, 19.77; p < 0.01); adherence was lower for other highly active DMTs (Coeff = −0.07; 95%CI = −0.10, −0.04; p < 0.01) and low-/medium-efficacy DMTs (Coeff = −0.16; 95%CI = −0.19, −0.14; p < 0.01). monthly DMT costs were higher for other highly active DMTs (Coeff = 77.45; 95%CI = 29.36, 125.53; p < 0.01) but lower for low-/medium-efficacy DMTs (Coeff = −772.31; 95%CI = −816.95, −727.66; p < 0.01). The hospital admissions and related costs of MS were similar between ocrelizumab, other highly active DMTs, and other low-/medium-efficacy DMTs, and with ocrelizumab as the first-line DMT after other highly active DMTs and after low-/medium-efficacy DMTs, which was possibly due to the low number of observations. Conclusions: From 2018 to 2022, ocrelizumab was among the most frequently prescribed DMTs, with 28.8% prescriptions to incident MS patients, confirming its relevance in clinical practice. Ocrelizumab was associated with the highest persistence and adherence, pointing towards its favorable benefit–risk profile. The costs of ocrelizumab were lower than those of other highly active DMTs.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 71%

Utilization of Ocrelizumab within Different Treatment Strategies for Multiple Sclerosis: A 5-Year Population-Based Study

Moccia,

Affinito,

Marrazzo

et al. 2024

Neurology International

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“…Several studies have investigated the cost-effectiveness of Ocrelizumab in RRMS treatment, supporting the favorable results observed in our study. Martins et al [17] conducted a cost-effectiveness analysis comparing Ocrelizumab with other treatments and found it to be a cost-effective option. Similarly, Yang et al…”

Section: Discussionmentioning

confidence: 99%

Ocrelizumab for the treatment of relapsing remitting multiple sclerosis: A cost effectiveness study in Peru

Gutiérrez-Aguado

Angeles-Donayre

2023

Preprint

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Background: This study examines the cost-effectiveness of Ocrelizumab, a treatment for relapsing-remitting multiple sclerosis (RRMS), in the Peruvian healthcare system. RRMS is a chronic autoimmune disease affecting the central nervous system, and its prevalence in Peru has been reported to be 9.12 cases per 100,000 inhabitants. Methods: A cohort multi-state Markov model was developed to simulate disease progression and evaluate the cost-effectiveness of Ocrelizumab compared to other treatment alternatives for RRMS. The model considered various health states, including relapse, disability progression, conversion to secondary-progressive MS, mortality, treatment effect waning, treatment withdrawal, and adverse events. Costs associated with medication, administration, monitoring, and adverse events were included. Quality-adjusted life years (QALYs) and life years (LYs) gained were analyzed using the EQ-5D-5L questionnaire. Results: In the base-case scenario, Ocrelizumab was found to be a cost-effective intervention, with a cost per QALY and LYs below the willingness-to-pay threshold. When compared to other treatment alternatives, Ocrelizumab was dominant, providing greater QALYs and LYs at a lower cost than Interferon, Natalizumab, Teriflunomide, and Alemtuzumab. However, Alemtuzumab had a higher cost but provided more QALYs and LYs than Ocrelizumab. Conclusions: Ocrelizumab was deemed cost-effective in the treatment of RRMS in Peru. It offered a favorable balance between cost and health outcomes, making it a compelling choice for RRMS management and resource allocation. The study's findings align with previous research highlighting the cost-effectiveness of Ocrelizumab in RRMS treatment across different healthcare systems. Limitations include the simplifications made in the model and the availability and accuracy of data sources used.

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“…Of the included studies, twenty-four studies were carried out in European countries, seven in the United States, four in Canada, six in Iran, four in Saudi Arabia, one in Thailand, one in Colombia, one in Chile, and one in Lebanon. Thirteen studies conducted CEA using a Markov model [18,[22][23][24][25][26][27][28][29][30][31][32][33][34], eight studies conducted CUA using a Markov model [35][36][37][38][39][40][41][42], one study conducted CUA Were the perspective of the analysis (health system, third-party payer, etc.) and reason for its selection stated?…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Eight studies analyzed both oral and intravenous infusions DMDs of RRMS [32,38,40,44,54,55,57,58]. Ten studies analyzed all three types of DMDs of RRMS [13,19,23,33,34,37,49,53,56,64]. In four studies, in addition to these three forms of medication, the BSC strategy was included in cost-effectiveness analysis [13,33,34,37].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing–remitting multiple sclerosis: a systematic review

Gallehzan,

Khosravi,

Jamebozorgi

et al. 2024

Health Econ Rev

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Background Multiple sclerosis (MS) is a chronic, autoimmune, and inflammatory disease. The economic burden of MS is substantial, and the high cost of Disease-modifying drugs (DMDs) prices are the main drivers of healthcare expenditures. We conducted a systematic review of studies evaluating the cost-utility and cost-effectiveness of DMDs for relapsing–remitting multiple sclerosis (RRMS). Materials and method Searches were conducted in PubMed, Web of Science, Scopus, and Embase. The search covered articles published between May 2001 and May 2023. Studies that were written in English and Persian and examined the cost-utility and cost-effectiveness of DMDs in patients with MS were included in our review. Data extraction was guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, and the quality of economic evaluations was assessed using the Quality of Health Economics Studies Instrument (QHES). All costs were converted to 2020 U.S. dollars using Purchasing Power Parity (PPP). Results The search yielded 1589 studies, and 49 studies were eligible for inclusion. The studies were mainly based on a European setting. Most studies employed Markov model to assess the cost–effectiveness. The lowest and highest numerical value of outcome measures were -1,623,918 and 2,297,141.53, respectively. Furthermore, the lowest and highest numerical value of the cost of DMDs of RRMS were $180.67, and $1474840.19, respectively. Conclusions Based on the results of all studies, it can be concluded that for the treatment of patients with MS, care-oriented strategies should be preferred to drug strategies. Also, among the drug strategies with different prescribing methods, oral disease-modifying drugs of RRMS should be preferred to injectable drugs and intravenous infusions.

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Cost-effectiveness Analysis of Ocrelizumab for the Treatment of Relapsing and Primary Progressive Multiple Sclerosis in Portugal

Cited by 5 publications

References 52 publications

Utilization of Ocrelizumab within Different Treatment Strategies for Multiple Sclerosis: A 5-Year Population-Based Study

Utilization of Ocrelizumab within Different Treatment Strategies for Multiple Sclerosis: A 5-Year Population-Based Study

Ocrelizumab for the treatment of relapsing remitting multiple sclerosis: A cost effectiveness study in Peru

Cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing–remitting multiple sclerosis: a systematic review

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