Cost-effectiveness of interferon beta-1a, interferon beta-1b, and glatiramer acetate in newly diagnosed non-primary progressive multiple sclerosis

Lisa A. Prosser, Karen M. Kuntz, Amit Bar-Or, Milton C. Weinstein

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

Objective: To perform a cost-effectiveness analysis of three immunomodulatory treatments for newly diagnosed nonprimary progressive MS: Interferon beta-1a, interferon beta-1b, and glatiramer acetate. Methods: We developed a state-transition model to estimate the health effects and costs associated with interferon beta-1a, interferon beta-1b, glatiramer acetate, and no treatment for hypothetical cohorts of men and women with non-primary progressive MS. We used the Expanded Disability Status Scale as the measure of disability and included both relapses and disease progression in the model. We evaluated treatment strategies assuming a 10-year treatment duration using the societal perspective. We elicited preferences for disability and treatment states using standard-gamble questions and modeled the disutility associated with treatment administration and side effects explicitly. Main outcome measures were net gains in quality-adjusted life expectancy and incremental cost-effectiveness ratios in dollars per quality-adjusted life year (QALY) gained. Results: For treatment duration of 10 years for newly diagnosed non-primary progressive MS, interferon beta-1a yielded the largest gain in quality-adjusted life expectancy with an incremental cost-effectiveness ratio of $2,200,000/QALY for women and $1,800,000/QALY for men, compared with no treatment. For a 5-year treatment duration, a "no treatment" strategy yielded more quality-adjusted life years than any of the treatment strategies. Cost-effectiveness ratios were similar for all three immunomodulatory treatments evaluated. Conclusions: Cost-effectiveness results for all three immunomodulatory treatments for MS were unfavorable in the simulated study population under a wide range of assumptions. For treatment duration less than or equal to 5 years, expected benefits of treatment may not outweigh disutility associated with side effects and treatment discomfort.

Original languageEnglish (US)
Pages (from-to)554-568
Number of pages15
JournalValue in Health
Volume7
Issue number5
DOIs
StatePublished - 2004

Bibliographical note

Funding Information:
This study was funded in part by a dissertation grant from the National Multiple Sclerosis Society, the Harvard Program on the Economic Evaluation of Medical Technology, the Harvard Center for Risk Analysis, and the Thomas O. Pyle Fellowship (Harvard Pilgrim Health Care and Harvard Medical School). The funding sources played no role in the design, methods, data collection, analysis or interpretation of the results of the study.

Keywords

  • Beta interferon
  • Cost-effectiveness
  • Glatiramer acetate
  • Multiple sclerosis

Fingerprint

Dive into the research topics of 'Cost-effectiveness of interferon beta-1a, interferon beta-1b, and glatiramer acetate in newly diagnosed non-primary progressive multiple sclerosis'. Together they form a unique fingerprint.

Cite this