Budget Impact Analysis of Dimethyl Fumarate for the Treatment of Relapsing-Remitting Multiple Sclerosis in Algeria

OBJECTIVES: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, that often leads to substantial disability in most patients. Relapsing-remitting MS (RRMS) is the most common type of MS at disease onset. Dimethyl fumarate (DMF) is the first oral treatment entering Algeria for patients with RRMS. We aim to assess the financial impact of introducing DMF to Algerian market.

METHODS: A budget impact model was conducted over 5 years from Algerian public payer perspective. We evaluated the annual financial consequences of DMF (60,223.99 DZD/month) introduction to current existing therapies which are Interferon βeta 1A Injection 44 microgram (81,828 DZD/month), Interferon βeta 1A Injection 30 microgram (81,828 DZD/month), Interferon βeta 1B 250 micrograms (76,141.95 DZD/month) and Glatiramer 40mg/ml (99,439.64 DZD/month). Current Market shares were estimated from IQVIA forecast and DMF was assumed to capture an annual share of 10% (first year) then 5% thereafter. Incident and Prevalent RRMS cases in Algeria were calculated from published data, and we assumed that 50% of the newly diagnosed RRMS patients would be started on DMF.

Annual cost of medications, adverse effects, Lab tests and medical consultations were included in the model. The costs associated with relapses were not included due to limitations of obtaining them in Algeria.

RESULTS: DMF introduction to Algerian market demonstrated a cumulative cost savings of 2,470,028,848 DZD/RRMS population over 5 years, having an average annual budget impact of -1.7% in first year and -5.9% onwards. The main driver for the results is the drug acquisition cost of DMF. The relapse costs could have added additional cost-savings due to lower reported relapse rates with DMF.

CONCLUSIONS: The inclusion of DMF in Algerian public drug formulary is associated with substantial cost-savings to the healthcare budget. Our findings may result in an increased treatment access for patients with RRMS.