PND55 Socioeconomic Value of Ocrelizumab in the Treatment of Patients with Primary Progressive Multiple Sclerosis

Abstract

Ocrelizumab is the only disease-modifying therapy (DMT) approved for patients with primary progressive multiple sclerosis (PPMS). We assessed benefits derived from the use of ocrelizumab in PPMS in the UK from a socioeconomic perspective, using best supportive care (BSC) as a comparator. A Markov-state model based on 1-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 a natural history study, respectively. Treatment effect on delaying disability progression was modeled through the hazard ratio for time to 12-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 a cross-sectional study of patients with multiple sclerosis that was published in 2017 or from national statistics databases. Data on PPMS prevalence and proportion of patients receiving BSC in the UK were obtained from Roche epidemiologic forecasts and a real-world study, respectively. The socioeconomic value of ocrelizumab versus BSC in the UK is estimated to be GBP77.2 million over 5 years. These cost savings are driven by informal care (GBP33.3 million), productivity loss (GBP16.5 million), community services (GBP14.8 million), and disability support pensions (GBP9.1 million). Data may be presented for additional countries. Ocrelizumab for PPMS offers substantial socioeconomic benefits versus BSC in the UK, suggesting that increasing the use of DMT could be of value to patients, caregivers, and healthcare systems.