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

Abstract

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.