October 17, 2017
Ocrelizumab provides greater value to relapsing forms of multiple sclerosis (RRMS) patients compared with subcutaneous interferon beta-1a (IFNβSC), according to a recent investigation. Initiating ocrelizumab at lower Expanded Disability Status Scale (EDSS) levels leads to a greater cumulative value due to slower disability progression, which extends years with higher quality-of-life.
A Markov model was developed to compare disability progression as measured by EDSS and relapse outcomes over a 30-year horizon for ocrelizumab vs IFNβSC. Direct, indirect, and informal costs (2016 US dollars) and utilities for EDSS health states were obtained from the literature. Investigators found:
Ocrelizumab was associated with an incremental gain of 0.84 quality-adjusted life years (QALYs) and cost savings of $287,713 relative to IFNβSC, resulting in an incremental net monetary benefit (INMB) of $413,611 per person over 30 years.
The INMB increased by $151,763 for those initiating ocrelizumab at EDSS level 1 vs level 4.
Influential parameters were QALY value, treatment costs, and disability progression; however, all sensitivity analyses indicated that the INMB for ocrelizumab relative to IFNβSC was ≥$300,000 per person.
Citation:
Frasco MA, Shih T, Incerti D, Espinosa OD, Vania DK, Thomas N. Incremental net monetary benefit of ocrelizumab relative to subcutaneous interferon β-1a. J Med Econ. 2017;20(10):1074-1082. doi:10.1080/13696998.2017.1357564.
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