PND16 Socioeconomic Value of Ocrelizumab in the Treatment of Patients with Primary Progressive Multiple Sclerosis

Abstract

Ocrelizumab is the first and only disease-modifying therapy (DMT) approved by Health Canada for patients with primary progressive multiple sclerosis (PPMS). In this study, we assess the socioeconomic benefits derived from using ocrelizumab in PPMS compared with best supportive care (BSC) in Canada. A Markov-state model based on one-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 ORATORIO trial and MSBase natural history study, respectively. Treatment effect on delaying disability progression was modeled through the hazard ratio for time to 24-week confirmed disability progression, which was derived from a counterfactual analysis of the ORATORIO double-blind and open-label extension phases. 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 published studies in the multiple sclerosis space or from national statistics databases. Data on PPMS prevalence and proportion of patients receiving BSC in Canada were obtained by triangulating Canadian epidemiologic data, Roche PPMS market share forecast, and real world data from the Ocrevus patient support program. The socioeconomic value of ocrelizumab compared with BSC in Canada is estimated to be CAD$61.3 million over 5 years. These cost savings are driven by reduction in the utilization of healthcare resources and community services ($33.1 million), productivity loss ($13.8 million), and informal care ($10.8 million). Ocrelizumab for PPMS offers substantial socioeconomic benefits compared with BSC in Canada.