OBJECTIVES

The purpose of this model-based cost-utility analysis (CUA) was to compare the costs and quality-adjusted life years (QALYs) of teriflunomide in naÏve patients vs. patients who had been previously treated with other disease-modifying therapies (DMTs) for Relapsing-Remitting Multiple Sclerosis (RRMS) in Italy.

METHODS

A four health states Markov model stretching over a 7-year timespan through annual cycles was developed to support the CUA.

Clinical, demographic and economic data for populating Markov model were mainly obtained from the analysis of a questionnaire administered to four Italian neurologist experts in the diagnosis and therapy of MS and geographically representative of the Italian reality, as well as from research assumptions and literature.

As the CUA followed both the healthcare sector and the societal viewpoints, both healthcare and non-healthcare resources were valued.

Costs and QALYs were discounted at 3% real social discount rate.

The cost-utility ratio (ICUR) was contrasted with an informal range of acceptability suggested for Italy (€25,000 - €40,000 per incremental QALY gained).

Univariate and probabilistic sensitivity analyses tested the robustness of the baseline findings.

RESULTS

When compared to patients who have been previously treated with different DMTs, teriflunomide in RRMS naÏve patients is strongly dominant in baseline CUA, both from the healthcare sector (-€1,042.68 and +0.480 QALYs) and societal perspectives (-€6,782.81 and +0.480 QALYs).

Cost-effectiveness acceptability curve shows that, for a willingness to pay of €40,000, the probability that teriflunomide is cost-effective in RRMS naÏve patients is 95.37% (healthcare sector perspective) and 95.89% (societal perspective).

CONCLUSIONS

Teriflunomide in RRMS naÏve patients is cost-effective and possibly strongly dominant from both the healthcare sector and the society viewpoints in Italy.