OBJECTIVES: To develop a cost-effectiveness analysis of ocrelizumab versus other first-line treatment alternatives (interferons, dimethyl fumarate, glatiramer acetate, teriflunomide, and fingolimod) for highly active relapsing-remitting multiple sclerosis from the perspective of the Chilean public health system.

METHODS: Using a Markov model developed from the perspective of the Chilean public health system and a lifetime time horizon for patients with highly active relapsing-remitting multiple sclerosis, the cost-effectiveness of ocrelizumab was evaluated against other alternatives used as first-line treatment, considering the effectiveness, safety, and quality of life parameters reported in the literature and the total costs of care calculated using a micro-costing methodology according to official cost sources in the country. The outcome assessed was quality-adjusted life years (QALYs). The cost-effectiveness threshold of 3 gross domestic product (GDP) per capita per incremental quality-adjusted life year calculated at USD 49.506,84 was considered.

RESULTS: Ocrelizumab was the technology with the highest number of QALYs (10,367) and was cost-effective compared to its comparators with incremental cost-effectiveness ratios (ICERs) of USD 24.601,80 in comparison to some interferons and up to USD 45.417,12 compared to fingolimod.

CONCLUSIONS: Ocrelizumab is a cost-effective alternative for treating patients with highly active relapsing-remitting multiple sclerosis in the Chilean setting as first-line treatment.