Cost-Utility Analysis of Medications for Relapsing-Remitting Multiple Sclerosis: A United States Third-Party Payer Perspective

Abstract

Background: Many new disease-modifying therapies (DMTs) have recently been approved for relapsing-remitting multiple sclerosis (RRMS) in the United States. Objective: To assess the values of 10 first-line therapies for RRMS, including generic glatiramer acetate, versus the natural history of disease for a newly diagnosed RRMS patient. Perspective: United States third-party payer. Methods: A Markov model was developed and estimates were made using data on natural history of disease progression, annual relapse rates, medication efficacy, costs, and utilities to determine incremental cost-effectiveness ratios (ICERs). Results: Base case is a cohort of 30-year-old females at Extended Disability Status Scale (EDSS) state 0 at a 20 year time horizon versus the natural history of disease. Dimethyl fumarate demonstrates the lowest ICER at $895,073/QALY. Conclusions: DMTs for RRMS have low value versus the natural history of disease, and would not be considered cost-effective by conventional standards.