OBJECTIVES : Ocrelizumab is a high-efficacy disease modifying therapy (DMT) for patients with relapsing forms of multiple sclerosis (RMS). We assessed benefits derived from the use of ocrelizumab in RMS in the UK from a socioeconomic perspective, using dimethyl fumarate, natalizumab and cladribine as comparators.

METHODS : A Markov-state model based on 1-point spaced Expanded Disability Status Scale (EDSS) states (0–9) was used to estimate costs associated with disease progression. EDSS at baseline and transition probabilities were derived from the OPERA trials and a natural history study, respectively. Treatment effect on delaying disability progression was modeled through hazard ratios for time to 12-week confirmed disability progression, derived from a network meta-analysis. Societal benefits included savings in direct healthcare and non-healthcare costs, and indirect costs (including informal care and productivity loss, among others). Drug costs were excluded to focus on treatment benefits. Resource use and cost inputs at 2019 prices were derived from a cross-sectional study of patients with multiple sclerosis that was published in 2017 or from national statistics databases. Data on RMS prevalence and proportion of patients treated with DMTs in the UK were obtained from Roche epidemiologic forecasts and a real-world study, respectively.

RESULTS : The socioeconomic value of ocrelizumab versus dimethyl fumarate, natalizumab, and cladribine in the UK is estimated to be GBP72.2 million, GBP27.9 million and GBP18.7 million over 5 years, respectively. These cost savings are mostly driven by informal care (GBP27.9 million, GBP10.7 million and GBP7.2 million) and productivity loss (GBP23.5 million, GBP9.2 million and GBP6.1 million); values versus dimethyl fumarate, natalizumab, and cladribine, respectively. Data may be presented for additional countries.

CONCLUSIONS : Ocrelizumab for RMS offers substantial socioeconomic benefits versus relevant first- and second-line DMTs in the UK. Starting high-efficacy DMTs early in treatment could be of value to patients with RMS, caregivers, and healthcare systems.