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Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective.
PLoS One. 2016; 11(3):e0150703.Plos

Abstract

OBJECTIVES

The paper aimed to estimate the incremental cost-effectiveness ratio (ICER) at the public published price for delayed-release dimethyl fumarate versus relevant Multiple Sclerosis disease-modifying therapies available in France in June 2015.

METHODS

The economic model was adapted to the French setting in accordance with the Haute Autorité de Santé guidelines using a model previously developed for NICE. A cohort of Relapsing Remitting Multiple Sclerosis patients was simulated over a 30-year time horizon. Twenty one health states were taken into account: Kurtzke Expanded Disability Status Scale (EDSS) 0-9 for Relapsing Remitting Multiple Sclerosis patients, EDSS 0-9 for Secondary Progressive Multiple Sclerosis patients, and death. Estimates of relative treatment efficacy were determined using a mixed-treatment comparison. Probabilities of events were derived from the dimethyl fumarate pivotal clinical trials and the London Ontario Dataset. Costs and utilities were extracted from the published literature from both the payer and societal perspectives. Univariate and probabilistic sensitivity analyses were performed to assess the robustness of the model results.

RESULTS

From both perspectives, dimethyl fumarate and interferon beta-1a (IFN beta-1a) 44 mcg were the two optimal treatments, as the other treatments (IFN beta-1a 30 mcg, IFN beta-1b 250 mcg, teriflunomide, glatiramer acetate, fingolimod) were dominated on the efficiency frontier. From the societal perspective, dimethyl fumarate versus IFN beta-1a 44 mcg incurred an incremental cost of €3,684 and an incremental quality-adjusted life year (QALY) of 0.281, corresponding to an ICER of €13,110/QALY.

CONCLUSIONS

Despite no reference threshold for France, dimethyl fumarate can be considered as a cost-effective option as it is on the efficiency frontier.

Authors+Show Affiliations

Real World Strategy and Analytics, Mapi Group, Paris, France.Economie de Santé & Affaires Gouvernementales, Biogen France SAS, Nanterre, France.Economie de Santé & Affaires Gouvernementales, Biogen France SAS, Nanterre, France.Real World Strategy and Analytics, Mapi Group, Paris, France.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26987055

Citation

Chevalier, Julie, et al. "Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: a French Societal Perspective." PloS One, vol. 11, no. 3, 2016, pp. e0150703.
Chevalier J, Chamoux C, Hammès F, et al. Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective. PLoS One. 2016;11(3):e0150703.
Chevalier, J., Chamoux, C., Hammès, F., & Chicoye, A. (2016). Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective. PloS One, 11(3), e0150703. https://doi.org/10.1371/journal.pone.0150703
Chevalier J, et al. Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: a French Societal Perspective. PLoS One. 2016;11(3):e0150703. PubMed PMID: 26987055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-Effectiveness of Treatments for Relapsing Remitting Multiple Sclerosis: A French Societal Perspective. AU - Chevalier,Julie, AU - Chamoux,Catherine, AU - Hammès,Florence, AU - Chicoye,Annie, Y1 - 2016/03/17/ PY - 2015/10/27/received PY - 2016/02/18/accepted PY - 2016/3/18/entrez PY - 2016/3/18/pubmed PY - 2016/8/9/medline SP - e0150703 EP - e0150703 JF - PloS one JO - PLoS One VL - 11 IS - 3 N2 - OBJECTIVES: The paper aimed to estimate the incremental cost-effectiveness ratio (ICER) at the public published price for delayed-release dimethyl fumarate versus relevant Multiple Sclerosis disease-modifying therapies available in France in June 2015. METHODS: The economic model was adapted to the French setting in accordance with the Haute Autorité de Santé guidelines using a model previously developed for NICE. A cohort of Relapsing Remitting Multiple Sclerosis patients was simulated over a 30-year time horizon. Twenty one health states were taken into account: Kurtzke Expanded Disability Status Scale (EDSS) 0-9 for Relapsing Remitting Multiple Sclerosis patients, EDSS 0-9 for Secondary Progressive Multiple Sclerosis patients, and death. Estimates of relative treatment efficacy were determined using a mixed-treatment comparison. Probabilities of events were derived from the dimethyl fumarate pivotal clinical trials and the London Ontario Dataset. Costs and utilities were extracted from the published literature from both the payer and societal perspectives. Univariate and probabilistic sensitivity analyses were performed to assess the robustness of the model results. RESULTS: From both perspectives, dimethyl fumarate and interferon beta-1a (IFN beta-1a) 44 mcg were the two optimal treatments, as the other treatments (IFN beta-1a 30 mcg, IFN beta-1b 250 mcg, teriflunomide, glatiramer acetate, fingolimod) were dominated on the efficiency frontier. From the societal perspective, dimethyl fumarate versus IFN beta-1a 44 mcg incurred an incremental cost of €3,684 and an incremental quality-adjusted life year (QALY) of 0.281, corresponding to an ICER of €13,110/QALY. CONCLUSIONS: Despite no reference threshold for France, dimethyl fumarate can be considered as a cost-effective option as it is on the efficiency frontier. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26987055/Cost_Effectiveness_of_Treatments_for_Relapsing_Remitting_Multiple_Sclerosis:_A_French_Societal_Perspective_ DB - PRIME DP - Unbound Medicine ER -