Budget Impect Analysis.

Abstract

To quantify the number and costs of relapses avoided over 2 years in the first-line treatment of RRMS based on the findings of the Cochrane report. An Excel-based financial model estimated the relapses and costs incurred by a hypothetical cohort of 1000 RRMS patients treated with first-line disease-modifying drugs (DMDs). The modelled cohort evaluated the consequences of treatment with subcutaneous (SC) interferon beta-1a versus intramuscular (IM) interferon beta-1a, as this was the only comparison whose data quality was assessed as ‘high’ by the Cochrane Review (Filippini et al., 2013). Risk of relapse was based on the 2-year data from the Cochrane Review network meta-analysis. The analysis was performed from a US payer perspective. The cost of a relapse was sourced from Panitch et al., 2005, and adjusted to 2012 US dollars. Net annual cost of therapy was based on wholesale acquisition cost. Given the model’s short time horizon, disability-related costs were not included as these tend to be an important economic driver only over the long-term progression of the disease. In order to test how variability in the model’s inputs might impact the analysis’ results, two-way sensitivity analyses were performed based on the reported 95% risk of relapse credible intervals for SC interferon beta-1a and IM interferon beta-1a In a hypothetical cohort of 1000 RRMS patients, treatment with SC interferon beta-1a is expected to result in the avoidance of 173 (sensitivity analysis range: -20 to 399) relapses versus IM interferon beta-1a over 2 years. Assuming a direct cost of relapse of $5141, this represents a savings of $890,212 (sensitivity analysis range: -$102,138 to $2,052,934) versus IM interferon beta-1a. Subcutaneous interferon beta-1a is likely to result in fewer relapses and lower direct costs of relapse versus IM interferon beta-1a over a 2-year period treatment.