Objective: To assess the costs of oral treatment with fingolimod compared to intravenous infusion of natalizumab in MSers with relapsing-remitting multiple sclerosis (RRMS) in the Netherlands.
Results: Comparing fingolimod to natalizumab, the model predicted discounted incremental costs of -€2,966 (95%CI: -€4,209;-€1,801), -€6,240 (95%CI: -€8,800;-€3,879), -€15,328 (95%CI: -€21,539;-€9,692) and -€28,287 (95%CI: -€39,661;-€17,955) over a 1, 2, 5, and 10-year time horizon, respectively. These predictions were most sensitive to changes in the costs of natalizumab infusion. Changing these costs of €255 within a range from €165 to €364 per infusion, resulted in cost savings varying from €4,031 to €8,923 after 2 years. The additional break-even analysis showed that infusion costs – including aseptic preparation of the natalizumab solution – needed to be as low as the respective costs of €94 and €80 to obtain a cost neutral result after 2 and 10 years. Limitations Neither treatment discontinuation and subsequent re-initiation nor patient compliance were taken into account. As a consequence of the applied cost-minimization technique, only direct medical costs were included.
Conclusion: The present analysis showed that treatment with fingolimod resulted in considerable cost savings compared to natalizumab: starting at €2,966 in the first year, increasing to a total of €28,287 after 10 years per RRMS patient in the Netherlands.