Pharmacoeconomics of synthetic therapies for multiple sclerosis

ABSTRACT

Introduction: Recently, the economic impact of multiple sclerosis (MS), which includes both direct and indirect costs, has been increasing. While direct costs comprise health-care costs, such as the cost of pharmaceuticals, additional treatments such as physiotherapy, and medical aids, indirect costs are triggered by the productivity loss of patients and caregivers. Although new drugs for MS have changed the therapeutic scenario, they have increased the direct costs of health-care services.

Areas covered: This review describes the pharmacoeconomic aspects of synthetic therapies for MS. Additionally, it discusses the economic impact of the various classes of licensed disease-modifying treatments (DMTs) for relapsing forms of MS.

Expert opinion: The emerging and more expensive DMTs for MS represent a considerable challenge for health-care systems and resource consumption. Future research should focus on the long-term efficacy of DMTs and the cost of treating MS in a real-life setting. Future biological and radiological biomarkers could help stratify patients at early stages of MS, helping physicians design a personalized therapeutic approach that could have a positive impact in economic terms.

KEYWORDS:

• Multiple sclerosis
• natalizumab
• pharmacoeconomics
• fingolimod
• interferons
• synthetic drugs

Article Highlights

• The frequency of cost-effectiveness analyses increased after the 2000s.

• HTAs’ approach aims to focus on aspects such as patient utility, quality of life, and ethical issues.

• The Markov model evaluating the probability of transition from one health state to the other is the most used model.

• Direct and indirect costs and a gain in QALYs outweigh the costs of DMTs.

• Resource-saving and the degree of innovativeness should be evaluated with safety concerns.

Declaration of interest

E D’Amico has received personal fees from Biogen and Sanofi and travel funding from Bayer Healthcare, Biogen, Novartis, Sanofi and Merck & Co. F Patti has served on the advisory boards of Bayer, Biogen, Celgene, Merck, Novartis, Roche, Sanofi, Teva, and Almirall. He has also received personal fees for speaking activities at congresses or sponsored symposia from Bayer, Biogen, Celgene, Merck, Novartis, Roche, Sanofi, Teva, and Almirall. CG Chisari has received personal fees from Biogen and Sanofi as well as travel funding from Bayer, Biogen, Novartis, Almirall, Roche and Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.