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

• DOI: 10.1007/s41669-022-00381-z
• Publication Date: 2022-12-01T13:53:36Z
• Authors: Paulo Martins; Björn Vandewalle; Jorge Félix; Carlos M. Capela; João J. Cerqueira; António V. Salgado; Diana G. Ferreira; Isabel Monteiro
• Keywords: Ocrelizumab; Natalizumab; Glatiramer acetate; Mallinckrodt

Ocrelizumab demonstrated significant clinical benefit for the treatment of relapsing (RMS) and primary progressive (PPMS) multiple sclerosis (MS), an incurable disease characterized by disability progression. This study evaluated economic impact ocrelizumab relative to current practice, including other disease-modifying therapies (DMT), available in Portugal.Markov models MS were adapted estimate across three patient populations: treatment-naïve RMS, previously treated PPMS. Health states defined according Expanded Disability Status Scale. For model further captured occurrence relapses progression secondary (SPMS). A lifetime time-horizon Portuguese societal perspective adopted.For RMS patients, was estimated maximize expected time (years) without SPMS (10.50) natalizumab (10.10), dimethyl fumarate (8.64), teriflunomide (8.39), fingolimod (8.38), interferon β-1a (8.33) glatiramer acetate (8.18). As most effective option, with quality-adjusted life year (QALY) gains between 0.3 1.2, found be cost-saving fingolimod, presented incremental cost-effectiveness ratios (ICER) below €16,720/QALY remaining DMT. PPMS ICER versus best supportive care at €78,858/QALY.Ocrelizumab provides important health benefits comparing favourably widely used therapies. In revealed either or have costs-per-QALY likely commonly accepted thresholds. PPMS, fills a clear gap practice. Overall, is provide good value money addressing need patients.