PharmacoEconomics & Outcomes News 804, p21 - 2 Jun 2018 Natalizumab cost effective versus fingolimod for RRMS Natalizumab (NTZ) appears to be cost effective compared with fingolimod (FTY) for second-line treatment in patients with highly active relapsing- remitting multiple sclerosis (RRMS), according to findings of a study presented as a poster at the 70th Annual Meeting of the American Academy of Neurology. A Markov model populated with real-world data from the MSBase Registry was used to evaluate the cost- effectiveness of switching to natalizumab versus fingolimod in patients with highly active RRMS and inadequate response to first-line therapies, from the perspective of NHS Scotland over a lifetime time horizon. MSBase data showed that switching to natalizumab significantly reduced the annualised relapse rate (p<0.001) and significantly increased the likelihood of disability improvement at six months (p<0.001) compared with switching to other first-line therapies. In the base-case analysis, natalizumab was estimated to achieve a greater QALY gain compared with ** – per fingolimod (+0.393) at a lower cost ( £19 148 patient), and therefore dominated (more effective and less costly) fingolimod. Natalizumab was also dominant in other scenarios including a societal perspective, and a 10-year time horizon. Natalizumab remained dominant when the price of fingolimod price was discounted by up to 23.2%, and was cost effective at a willingness-to-pay threshold of £30 000 QALY gained when the price of fingolimod price was discounted by up to 37.6%. "Because FTY is covered by a confidential patient access scheme in the UK, discounts on the FTY list price were considered in scenario analyses," noted the authors. "NTZ remained dominant across one-way and probabilistic sensitivity analyses (SAs) and a range of alternative scenarios and was likely to be cost effective compared with FTY with up to a 32.8%–37.6% discount on the price of FTY at willingness-to-pay (WTP) thresholds of £20,000–£30,000 per QALY gained," they said. * National Health Service ** 2016 British pounds Herring W, et al. A cost-effectiveness analysis using real-world data from the MSBase registry: comparing natalizumab to fingolimod in patients with inadequate response to disease- modifying therapies in relapsing-remitting multiple sclerosis (RRMS) in Scotland. 70th Annual Meeting of the American Academy of Neurology : (plus poster) abstr. 364, 21 Apr 2018. 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804
PharmacoEconomics & Outcomes News – Springer Journals
Published: Jun 2, 2018
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