Costs and effectiveness of fingolimod versus alemtuzumab in the treatment of highly active relapsing-remitting multiple sclerosis in the UK: re-treatment, discount, and disutility

Montgomery, Stephen; Kusel, J.; Nicholas, Richard; Adlard, Nicholas

doi:10.1080/13696998.2017.1345748

Cited by 15 publications

(39 citation statements)

References 24 publications

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“…Our review suggests that models differ in several assumptions (e.g., long-term treatment effect and EDSS improvement over time) and in the approach in estimating mortality rates. At the same time, there are similarities in modeling aspects, such as the type of model, model The discrete event simulation model can better capture the individual disease journey of MS patients, such as switching between DMTs, long-term AEs, and outcomes as well as individual patient's attributes or comorbidities [112,113] Model health states…”

Section: Discussionmentioning

confidence: 99%

“…Most studies (n = 94) and HTA reports (n = 25) constructed Markov cohort models. The remaining studies used spreadsheet-based cohort models (n = 9) [38,39,69,[104][105][106][107][108][109], discrete event simulation (DES; n = 4) [110][111][112][113], a simulated decision tree (n = 1) [114], individual-level simulation models (n = 3) [37,40,57,115], and microsimulation (n = 1) [116]. A consistent approach was seen in most studies that constructed Markov cohort models, wherein models were structured per the Expanded Disability Status Scale (EDSS), a widely used scale to quantify disability in MS.…”

Section: Modeling Approachmentioning

confidence: 99%

“…Considering the scarcity of data, it is recommended to conduct a sensitivity analysis with various sources of data inputs [190] b. [111][112][113]. Furthermore, it is important to highlight that only one model used in the HTA reports was a DES model and the rest were Markov cohort models, explaining the prominent use of Markov cohort model in economic evaluation studies in RMS.…”

Section: Edss-based Health Statesmentioning

confidence: 99%

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How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

Wiyani¹,

Badgujar

Khurana³

et al. 2021

Neurol Ther

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Introduction: The introduction of diseasemodifying therapies (DMTs) for relapsing multiple sclerosis (RMS) over the last two decades has prompted the economic assessments of these treatments by reimbursement authorities. The aim of this systematic literature review was to evaluate the modeling approach and data sources used in economic evaluations of DMTs for RMS, identify differences and similarities, and explore how economic evaluation models have evolved over time. Methods: MEDLINEÒ, EmbaseÒ, and EBM Reviews databases were searched using OvidÒ Platform from database inception on 25 December 2019 and subsequently updated on 17 February 2021. In addition, health technology assessment agency websites, key conference proceedings, and gray literature from relevant

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Section: Discussionmentioning

confidence: 99%

Section: Modeling Approachmentioning

confidence: 99%

Section: Edss-based Health Statesmentioning

confidence: 99%

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How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

Wiyani¹,

Badgujar

Khurana³

et al. 2021

Neurol Ther

Self Cite

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“…Although fingolimod resulted in lower acquisition costs across all tested scenarios, those advantages were offset by lower disease management costs associated with fewer relapses in the modelled cohort treated with alemtuzumab. 69…”

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of alemtuzumab in the management of relapse-remitting multiple sclerosis in Italy

Stanisic¹,

Bertolotto

Berto³

et al. 2019

Global & Regional Health Technology Assessment

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Multiple sclerosis is the most frequent cause of non-traumatic neurologic disability in young adults with over 3400 newly diagnosed cases annually in Italy. The research objective was to assess the cost-effectiveness of alemtuzumab in comparison with other disease-modifying therapies in the management of relapsing-remitting multiple sclerosis, from a payer perspective in Italy. A Markov model was created to assess cost-effectiveness of alemtuzumab in comparison with subcutaneous IFN β-1a, natalizumab and fingolimod. Treatment effects were derived from a network meta-analysis. Economic input included cost of therapies, their administration and follow-up, cost of adverse events and cost of relapse. Data on health care resource utilization and their costs were retrieved from published sources. Cost-effectiveness was measured as incremental cost (€, 2017) per quality-adjusted life year while the robustness of the results was demonstrated in sensitivity analyses. Over a lifetime horizon, alemtuzumab yielded more quality-adjusted life years and less costs compared to the other disease-modifying therapies in all base-case analyses. Treatment with alemtuzumab yielded an incremental quality-adjusted life years of 1.62, 1.03 and 1.36 with savings of €4312, €81,562 and €54,067 versus IFN β-1a, fingolimod and natalizumab, respectively. Results on the multiple cost-effectiveness acceptability curve showed alemtuzumab carries the highest likelihood of being below the accepted willingness-to-pay threshold (€40,000) compared to IFN β-1a, natalizumab and fingolimod. Based on the current analysis, alemtuzumab is likely to be costeffective versus IFN β-1a, natalizumab and fingolimod in the treatment of relapsing-remitting multiple sclerosis patients in Italy.

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“…Cette stratégie commerciale n'a pas été sans conséquences sur le plan financier en Europe. Le coût moyen du traitement par Lemtrada® sur 2 ans est estimé à environ 65 000 € (variable selon les pays), soit un tarif 40 fois plus élevé que le MabCampath® (soit 650 €/mg versus 14 €/mg) [3][4][5]. En France, le Lemtrada® a été commercialisé seulement en 2016 sur la base de l'avis favorable de la commission de transparence.…”

Section: Une Dénomination Commune Internationale Identique ; Des Communclassified

Dénominations et indications des anticorps face à la réglementation et aux pratiques des laboratoires pharmaceutiques

2019

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Les dénominations et les indications des anticorps monoclonaux thérapeutiques doivent répondre aux réglementations en vigueur, mais s’accompagnent du développement de stratégies commerciales autour des noms commerciaux. Certaines de ces pratiques obéissent à des considérations territoriales ou juridiques, tandis que d’autres sont motivées par de réelles préoccupations médicales. Enfin, certaines ont un impact financier non négligeable pour la collectivité.

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Costs and effectiveness of fingolimod versus alemtuzumab in the treatment of highly active relapsing-remitting multiple sclerosis in the UK: re-treatment, discount, and disutility

Abstract: When the model captured alemtuzumab re-treatment and long-term AE decrements, it was found that fingolimod is cost-effective compared to alemtuzumab, assuming application of only a modest level of confidential PAS discount.

Cited by 15 publications

References 24 publications

How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

How have Economic Evaluations in Relapsing Multiple Sclerosis Evolved Over Time? A Systematic Literature Review

The cost-effectiveness of alemtuzumab in the management of relapse-remitting multiple sclerosis in Italy

Dénominations et indications des anticorps face à la réglementation et aux pratiques des laboratoires pharmaceutiques

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