OBJECTIVES: To assess the effectiveness of disease-modifying therapies (DMTs) in patients with relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) in Albania, measured by life-years gained (LYG) and quality-adjusted life years (QALYs).

METHODS: A Markov model in Microsoft Excel was used to analyze two patient populations: RRMS patients treated with interferon beta-1a, interferon beta-1b, fingolimod, and ocrelizumab; and PPMS patients treated with ocrelizumab and best standard of care (BSC). Efficacy data from the OPERA 1 and 2 trials were used for RRMS population, and the ORATORIO study for PPMS. Health benefits were discounted at 3,5%. Results were presented as LYG and QALYs and adjusted using epidemiological data for the number of MS patients on- and off-treatment in Albania.

RESULTS: The modelled populations with RRMS and PPMS treated with ocrelizumab gained additional LYG and QALYs compared to interferon beta-1a (+0,29 LYG and +1,27 QALYs), interferon beta-1b (+0,34 LYG and +1,53 QALYs), fingolimod (+0,31 LYG and +1,36 QALYs) for RRMS, and BSC (+0,18 LYG and +0,53 QALYs) for PPMS. Adjusting the epidemiological data showed that for every Albanian MS patient on (any) DMT treatment with interferon beta-1a, interferon beta-1b, fingolimod or ocrelizumab, there is an average increase of +17,77 LYG and +8,12 QALYs. Among 923 MS patients in Albania, in 2024, 158 (17,12%) are being treated and 765 (82,88%) are not, leading to a total loss of 13 592,46 LYG and 6 214,77 QALYs for all untreated patients.

CONCLUSIONS: Ocrelizumab improves life expectancy and quality of life compared to interferon beta-1a, interferon beta-1b, and fingolimod for RRMS, and BSC for PPMS. The loss of health benefits for untreated patients highlights the need for better MS treatment access in Albania. Improving access will yield significant health, economic, and social benefits for patients and their families.