Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
Spelman, Tim (Karolinska Institute (Estocolm, Suècia))
Herring, William L. (Karolinska Institute (Estocolm, Suècia))
Acosta, Carlos (Value and Access, Biogen (Baar, Suïssa))
Hyde, Robert (Medical, Biogen (Baar, Suïssa))
Jokubaitis, Vilija (Monash University (Melbourne, Austràlia))
Pucci, Eugenio (Neurology Unit. AST-Fermo (Fermo, Itàlia))
Lugaresi, Alessandra (IRCCS Istituto delle Scienze Neurologiche di Bologna (Bolonya, Itàlia))
Laureys, Guy (University Hospital Ghent (Gant, Bèlgica))
Havrdova, Eva Kubala (Charles University and General University Hospital (Praga, República Txeca))
Horáková, Dana (Charles University and General University Hospital (Praga, República Txeca))
Izquierdo, Guillermo (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Eichau, Sara (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Ozakbas, Serkan (Izmir University of Economics (Esmirna, Turquia))
Alroughani, Raed A. (Amiri Hospital (Kuwait))
Kalincik, Tomas (University of Melbourne (Austràlia))
Duquette, Pierre Pascal (CHUM and Universite de Montreal (Montreal, Canadà))
Girard, Marc (CHUM and Universite de Montreal (Montreal, Canadà))
Petersen, Thor (Aarhus University Hospital (Aarhus, Dinamarca))
Patti, Francesco (University of Catania (Sicília, Itàlia))
Csepany, Tunde (University of Debrecen (Debrecen, Hongria))
Granella, Franco (Parma University Hospital (Parma, Itàlia))
Grand'Maison, François (Neuro Rive-Sud (Quebec, Canadà))
Ferraro, Diana (Azienda Ospedaliera-Universitaria di Modena (Itàlia))
Karabudak, Rana (Hacettepe University (Ankara, Turquia))
José Sà, Maria (University Fernando Pessoa (Porto, Portugal))
Trojano, Maria (University of Bari (Itàlia))
van Pesch, Vincent (Université Catholique de Louvain (Lovaina, Bèlgica))
van Wijmeersch, Bart (Pelt and Hasselt University (Bèlgica))
Cartechini, Elisabetta (AST Macerata (Itàlia))
McCombe, Pamela A. (Royal Brisbane and Women's Hospital (Brisbane, Austràlia))
Gerlach, Oliver H. H. (Maastricht University (Països Baixos))
Spitaleri, Daniele Litterio A. (Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino (Itàlia))
Rozsa, Csilla S. (Jahn Ferenc Teaching Hospital (Budapest, Hongria))
Hodgkinson, Suzanne J. (Immune Tolerance Laboratory Ingham Institute and Department of Medicine. UNSW (Sydney, Austràlia))
Bergamaschi, Roberto (IRCCS Mondino Foundation (Pavia, Itàlia))
Gouider, Riadh (University of Tunis El Manar (Manouba, Tunísia))
Soysal, Aysun (Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases (Istanbul, Turquia))
Castillo-Triviño, Tamara (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Prevost, Julie (CSSS Saint-Jérôme(Canadà))
Garber, Justin Y. (Westmead Hospital)
de Gans, Koen (Groene Hart Ziekenhuis (Gouda, Països Baixos))
Ampapa, Radek (Ax Nemocnice Jihlava (República Txeca))
Simo, Magdolna (Semmelweis University Budapest (Hongria))
Sánchez-Menoyo, José Luis (Hospital de Galdakao (Usansolo, Biscaia))
Iuliano, Gerardo (Ospedali Riuniti (Itàlia))
Sas, Attila (BAZ County Hospital (Miskolc, Hongria))
van der Walt, A. (The Alfred Hospital (Melbourne, Austràlia))
John, Nevin (Monash Health (Melbourne, Austràlia))
Gray, Orla M. (South Eastern HSC Trust (Belfast, Irlanda))
Hughes, Stella E. (Royal Victoria Hospital (Belfast, Irlanda))
De Luca, Giovanna ("SS. Annunziata" University Hospital. University "G. d'Annunzio" (Chieti, Itàlia))
Onofrj, Marco (University G. d'Annunzio (Abruzzo, Itàlia))
Buzzard, Katherine A. (Royal Melbourne Hospital (Melbourne, Austràlia))
Skibina, Olga G. (Box Hill Hospital (Victòria, Austràlia))
Terzi, Murat (19 Mayis University (Samsun, Turquia))
Slee, Mark (Flinders University (Adelaide, Austràlia))
Solaro, Claudio Marcello (Mons.Luigi Novarese Hospital Moncrivello (Itàlia))
Oreja-Guevara, Celia (Hospital Clínico San Carlos (Madrid))
Ramo-Tello, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Fragoso, Yára Dadalti (Universidade Metropolitana de Santos (Brasil))
Shaygannejad, Vahid (Isfahan University of Medical Sciences (Esfahan, Iran))
Moore, Fraser G. A. (McGill University (Montreal, Canadà))
Rajda, Cecília (University of Szeged (Hongria))
Agüera-Morales, Eduardo (University of Cordoba (Còrdova, Andalusia))
Butzkueven, Helmut (Monash University (Melbourne, Austràlia))

Data:	2024
Resum:	Aim: To evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS). Methods: Real-world data from the MSBase Registry were obtained for patients with RES-RRMS who were previously either naive to disease-modifying therapies or had been treated with interferon-based therapies, glatiramer acetate, dimethyl fumarate, or teriflunomide (collectively known as BRACETD). Matched cohorts were selected by 3-way multinomial propensity score matching, and the annualized relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M) were compared between treatment groups. Comparative effectiveness results were used in a cost-effectiveness model comparing natalizumab and fingolimod, using an established Markov structure over a lifetime horizon with health states based on the Expanded Disability Status Scale. Additional model data sources included the UK MS Survey 2015, published literature, and publicly available sources. Results: In the comparative effectiveness analysis, we found a significantly lower ARR for patients starting natalizumab compared with fingolimod (rate ratio [RR] = 0. 65; 95% confidence interval [CI], 0. 57-0. 73) or BRACETD (RR = 0. 46; 95% CI, 0. 42-0. 53). Similarly, CDI6M was higher for patients starting natalizumab compared with fingolimod (hazard ratio [HR] = 1. 25; 95% CI, 1. 01-1. 55) and BRACETD (HR = 1. 46; 95% CI, 1. 16-1. 85). In patients starting fingolimod, we found a lower ARR (RR = 0. 72; 95% CI, 0. 65-0. 80) compared with starting BRACETD, but no difference in CDI6M (HR = 1. 17; 95% CI, 0. 91-1. 50). Differences in CDW6M were not found between the treatment groups. In the base-case cost-effectiveness analysis, natalizumab dominated fingolimod (0. 302 higher quality-adjusted life-years [QALYs] and £17,141 lower predicted lifetime costs). Similar cost-effectiveness results were observed across sensitivity analyses. Conclusions: This MSBase Registry analysis suggests that natalizumab improves clinical outcomes when compared with fingolimod, which translates to higher QALYs and lower costs in UK patients with RES-RRMS.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Multiple sclerosis ; Natalizumab ; Fingolimod ; Real-world data ; Comparative effectiveness ; Cost-effectiveness
Publicat a:	Journal of Medical Economics, Vol. 27 Núm. 1 (2024) , p. 109-125, ISSN 1941-837X

DOI: 10.1080/13696998.2023.2293379

19 p, 2.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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