PND18 Cost- Effectiveness of Fingolimod on Patients With Multiple Sclerosis at the Public Mexican Health Care System

Abstract

94.78 USD for pregabalin and gabapentin per patient respectively. Total costs per treatment were 478.15 and 514.73 USD for pregabalin and gabapentin treatments respectively, representing a cost-saving per patient of 36.58 USD for pregabalin. CONCLUSIONS: Pregabalin is a cost-saving option compared to gabapentin, representing a treatment that diminishes the health care system resource utilization while shortening patient's length of treatment and reducing the burden related to other concomitant medications used. OBJECTIVES:To model the value of screening for early Parkinson's Disease (PD). A model to evaluate lifetime economic value from slowing progression over the course of PD was adapted to assess sequential olfactory testing and dopamine transporter (DAT) imaging for screening for pre-motor disease in different patient groups. METHODS: Data from the PD Associated Risk Study (PARS) were used to parameterize the model. We assessed screening in patients aged 55 with varying risk: a general population; persons with a relative with PD; persons with LRRK2ϩ genotype; and persons with REM sleep disorder. PD prevalence per 100,000 at screening was 5, 20, 100 and 200 for these groups. Olfactory test and DAT costs were $15 and $2500. We assumed that disease modifying (DM) therapy was available that slowed disease progression by 20% at a cost of $35,000. Economic value was measured in terms of net monetary benefit (NMB), valuing quality-adjusted life-years at $50,000. RESULTS: Of those who took the olfactory test, 13.4% yielded positive results and also took the DAT. The sensitivity and specificity of screening were 64% and 99%. NMB for the four groups was -$211, $217, $2,495, and $5,344, indicating that screening has positive economic value in persons with a close relative with PD, persons with LRRK2ϩ genotype, and persons with REM sleep disorder. Screening value was positively correlated with rate of progression from preclinical to clinical PD, efficacy of DM therapy, and preclinical health utility. Screening value was negatively correlated with costs of false positives or false negatives, screening cost, age at preclinical onset, age at unscreened diagnosis, Hoehn and Yahr stage at which the unscreened diagnosis is made, and cost of DM therapy. CONCLUSIONS: Under certain scenarios, particularly in high risk groups, screening for early PD may be a cost effective strategy.