A health-economic evaluation of disease-modifying drugs for the treatment of relapsing-remitting multiple sclerosis from the German societal perspective

Objective: This analysis compared the cost-effectiveness of interferon beta-1a (IFNβ-1a) 44 μg SC with that of other available first-line treatments for relapsing-remitting multiple sclerosis (RRMS) from the German societal perspective in 2008.Methods: A decision-analytic model was used to estimate the cost-effectiveness of IFNβ-1a 44 μg SC given 3 times weekly compared with that of IFNβ-la 30 μg IM given once weekly, IFNβ-1b 8 mIU given every other day, and glatiramer acetate 20 mg SC given once daily. Data sources included the published literature, clinical trials, German price/tariff lists, and national population statistics. The time horizon of the model was 4 years, which was the maximum duration of follow-up in published clinical trials.Results: The cost-effectiveness (cost per relapse avoided) of IFNβ-la 44 μg SC compared with no active treatment was €51,250, which compared favorably with that of IFNβ-la 30 μg IM (€133,770), glatiramer acetate (€71,416), and IFNβ-1b (€54,475). When the cost of disease progression was excluded, the cost per relapse avoided remained favorable for IFNβ-1a 44 μg SC (€54,292) compared with the other options (€143,186, €72,809, and €56,816, respectively). Indirect comparison of each available treatment option with the next best alternative indicated that the incremental cost-effectiveness of IFNβ-la 44 μg SC (€23,449) was consistent with accepted thresholds. Sensitivity analyses in which the discount rate, frequency of relapse and disease progression, costs of relapse and disease progression, and adherence were varied did not affect the relative outcomes.Conclusion: In this analysis from the German societal perspective, IFNβ-la 44 μg SC had favorable overall cost-effectiveness versus no active treatment compared with other available disease-modifying drugs for the treatment of RRMS.