This study evaluated the cost-effectiveness of disease-modifying therapies (DMTs) in the United States and compared them to basic supportive therapy without DMTs.
Methods: Using a complicated method the researchers generated 10-year disease progression paths for a group of MS’ers. Medical costs and those associated with losses of employment were obtained from multiple sources. Outcomes were measured as gains in quality-adjusted life-years (QALY) and relapse-free years.
: Using DMT for 10 years resulted in modest health gains compared to treatment without DMT. The cost-effectiveness of all DMTs exceeded $800,000/QALY. Reducing the cost of DMTs would have the greatest impact on the cost-effectiveness of these treatments; for example cost reduction by 67% would improve the probability of Avonex being cost-effective at $164,000/QALY to 50%.
Conclusion: Use of DMT in MS results in health gains that come at a very high cost.
Epub before print: Noyes et al. DickCost-effectiveness of disease-modifying therapy for multiple sclerosis: A population-based studyNeurology July 20, 2011 WNL.0b013e3182270402.
“Deja vu! This is the kind of analysis that NICE does in the UK to test whether or not a drug is cost-effective. We believe NICE sets their threshold for chronic diseases in region of £35,000 to £40,000. This US study was limited to interferon-beta and glatiramer acetate and is not too dissimilar to what NICE originally found when they assessed these two classes of drug. Which is why we have to use them under a controlled scheme called the ‘Risk Sharing Scheme’. The price of DMTs in the US is a lot higher than in the UK. You can see why commissioner’s and healthcare providers find the costs of DMTs a problem. The other side of the coin is the effectiveness of these therapies; clearly we need more effective therapies to improve the cost-effectiveness ratio.”
Other relevant post on this blog:
23 May 2011
Royal Society of Medicine Lecture – “The Nice Or Not So Nice Lecture”. In this lecture Sir Michael Rawlings talks about the role of NICE in medicine today; this has major implications for PwMS. …