NDLI: Long-term cost-effectiveness model of interferon beta-1b in the early treatment of multiple sclerosis in the United States.

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Long-term cost-effectiveness model of interferon beta-1b in the early treatment of multiple sclerosis in the United States.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Pan, Feng Goh, Jo Wern Cutter, Gary Su, Wayne Pleimes, Dirk Wang, Cheng
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Pan F ( United BioSource Corporation, Bethesda, Maryland 20814, USA. feng.pan@unitedbiosource.com)
Abstract	BACKGROUND: Multiple sclerosis (MS) is a potentially debilitating autoimmune disease that affects the brain and spinal cord. Disease-modifying therapies have been shown to slow disease progression but were not believed to prolong the survival of patients with MS. The recent 21-Year Long-Term Follow-Up (21Y-LTF) study found a significant survival advantage for patients receiving early treatment with interferon beta (IFNß)-1b compared with placebo (no early treatment). OBJECTIVES: The aim of this study was to conduct cost-effectiveness analyses estimating the long-term benefit of early treatment with IFNß-1b among MS patients from a US societal perspective. METHODS: A Markov model was developed to simulate the experience of patients with MS from the 21Y-LTF study over a lifetime. Patients were randomized to receive either IFNß-1b or placebo for up to 5 years and then receive a variety of MS treatments (including no treatment) thereafter. Survival data reported from the 21Y-LTF study were incorporated into the model. The model assumes that patients' MS was managed in similar ways for both groups during the uncontrolled phase of the 21Y-LTF study (ie, survival difference between the 2 groups is the result of early use of IFNß-1b). Health outcomes were life-years and quality-adjusted life-years (QALYs). Costs included treatments, direct disease management, informal care, and lost productivities and were reported in 2011 US dollars. RESULTS: In the modeled placebo group, the median age at death was predicted to be 63.7 years, and the median survival time from disease onset was 36.7 years. Early treatment with IFNß-1b reduced the lost health benefits by 2.8 life-years and 1.9 QALYs, respectively, after discounting. Total discounted cost for IFNß-1b-treated patients was \$86,223 higher than that of patients receiving placebo. The incremental cost-effectiveness ratio was \$46,357 per QALY gained and \$30,967 per life-year gained. Sensitivity analyses indicate the robustness of the model's results. CONCLUSIONS: Treatment with IFNß-1b during the earlier disease phase of patients with MS significantly increased patient life-years and QALYs. IFNß-1b is likely to be a cost-effective intervention for MS.
File Format	HTM / HTML
ISSN	01492918
Issue Number	9
Volume Number	34
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2012-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Adjuvants, Immunologic Therapeutic Use Interferon-beta Models, Economic Multiple Sclerosis Drug Therapy Economics Aged Cost-benefit Analysis Disease Progression Drug Costs Follow-up Studies Humans Interferon Beta-1b Markov Chains Middle Aged Quality-adjusted Life Years Survival Rate Time Factors United States Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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