PND31 - Analysis Of Expenditure In Multiple Sclerosis Disease Modifying Therapies Evolution Between 2004-2015 In Spain

Abstract

To analyze factors of recent evolution of Multiple Sclerosis (MS) Disease Modifying Therapies (DMT) budgets in Spain between 2004 and 2015. 2004-2015 single DMT monthly expenditure was provided by IMS Health. For each DMT line: (First line: subcutaneous and intramuscular interferon (IFN) β-1a, subcutaneous IFN β-1b glatiramer acetate injection dimethyl fumarate and teriflunomide. Second line: natalizumab, alemtuzumab and fingolimod) were calculated monthly and annually evolution of number of patients, billing, drug cost per patient and cost per year of treatment. Two periods: 2004-2015 and 2007 (start marketing second lines DMT)-2015 period were analyzed for each DMT line. During 2004-2015 DMT expenditure increased from 115.5M€ to 397.3M€ due to: A greater number of patients 192% (10.28% annual growth per year) and a further growth of annual cost per patient: 17.79% (1.50 % annual growth per year). In December 2015 second lines correspond to a 38.39% of DMT expenditure. Annual cost per patient in second line represents 56% over cost per treated patient and 90% greater than first line DMT cost per year. If year 2007 is omitted from analysis (Only 68 second-line treatments and 1.44M€ of associated expense) and is analyzed 2008-2015 period, second-line DMT represent 47% of new treatments causing a 65% increase in DMT expenditure. In 2015 second line DMT participation reaches 38% of new regimens causing the 60.88% of increase DMT expenditure. The growing incorporation of new therapies and the appreciable rise in the number of treated patients (10.28 % annual growth per year) are components to consider in the pharmaceutical budget management.