1. Comparative Effectiveness and Cost-Effectiveness of Natalizumab and Fingolimod in Patients with Inadequate Response to Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis in the United Kingdom
- Author
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Spelman T., Herring W. L., Zhang Y., Tempest M., Pearson I., Freudensprung U., Acosta C., Dort T., Hyde R., Havrdova E., Horakova D., Trojano M., De Luca G., Lugaresi A., Izquierdo G., Grammond P., Duquette P., Alroughani R., Pucci E., Granella F., Lechner-Scott J., Sola P., Ferraro D., Grand'Maison F., Terzi M., Rozsa C., Boz C., Hupperts R., Van Pesch V., Oreja-Guevara C., van der Walt A., Jokubaitis V. G., Kalincik T., Butzkueven H., Luca G., UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de biochimie médicale, UCL - (SLuc) Service de neurologie, Spelman T., Herring W.L., Zhang Y., Tempest M., Pearson I., Freudensprung U., Acosta C., Dort T., Hyde R., Havrdova E., Horakova D., Trojano M., De Luca G., Lugaresi A., Izquierdo G., Grammond P., Duquette P., Alroughani R., Pucci E., Granella F., Lechner-Scott J., Sola P., Ferraro D., Grand'Maison F., Terzi M., Rozsa C., Boz C., Hupperts R., Van Pesch V., Oreja-Guevara C., van der Walt A., Jokubaitis V.G., Kalincik T., Butzkueven H., and Luca G.
- Subjects
Pharmacology ,Multiple Sclerosis ,Multiple Sclerosis, Relapsing-Remitting ,Fingolimod Hydrochloride ,Cost-Benefit Analysis ,Natalizumab ,Health Policy ,Public Health, Environmental and Occupational Health ,Humans ,multiple sclerosis, effectiveness, cost, natalizumab, fingolimod ,Immunosuppressive Agents - Abstract
Background: Patients with highly active relapsing-remitting multiple sclerosis inadequately responding to first-line therapies (interferon-based therapies, glatiramer acetate, dimethyl fumarate, and teriflunomide, known collectively as “BRACETD”) often switch to natalizumab or fingolimod. Objective: The aim was to estimate the comparative effectiveness of switching to natalizumab or fingolimod or within BRACETD using real-world data and to evaluate the cost-effectiveness of switching to natalizumab versus fingolimod using a United Kingdom (UK) third-party payer perspective. Methods: Real-world data were obtained from MSBase for patients relapsing on BRACETD in the year before switching to natalizumab or fingolimod or within BRACETD. Three-way-multinomial-propensity-score–matched cohorts were identified, and comparisons between treatment groups were conducted for annualised relapse rate (ARR) and 6-month–confirmed disability worsening (CDW6M) and improvement (CDI6M). Results were applied in a cost-effectiveness model over a lifetime horizon using a published Markov structure with health states based on the Expanded Disability Status Scale. Other model parameters were obtained from the UK MS Survey 2015, published literature, and publicly available UK sources. Results: The MSBase analysis found a significant reduction in ARR (rate ratio [RR]=0.64; 95% confidence interval [CI] 0.57–0.72; p 
- Published
- 2021
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