First-Year Cost of Administering and Monitoring Therapies for Multiple Sclerosis

Madrid—According to an interactive tool developed to estimate the first-year cost of administering and monitoring multiple sclerosis (MS) therapies, glatiramer acetate was the cheapest treatment option, followed by interferon beta-1a intramuscular injection, interferon beta-1a subcutaneous injection, interferon beta-1b subcutaneous injection, fingolimod, and natalizumab. The results were presented at the ISPOR European Congress in a poster titled Estimated Costs of First-Year Monitoring and Administration of Multiple Sclerosis Therapies in the United States. MS affects 2.5 million individuals and is associated with numerous chronic conditions. The US Food and Drug Administration (FDA) has approved several immunomodulatory agents to treat relapsing-remitting MS: glatiramer acetate subcutaneous injection, interferon beta-1a intramuscular injection, interferon beta-1a subcutaneous injection, interferon beta-1b subcutaneous injection, natalizumab intravenous infusion, fingolimod oral capsules, and mitoxantrone intravenous infusion. Fingolimod is the most recent FDA-approved treatment for MS, but the drug comes with a Risk Evaluation and Mitigation Strategy monitoring program. In this study, the authors developed an interactive tool to estimate the first-year monitoring costs for all of the treatment options except for mitoxantrone. They calculated costs using the estimated market share data, Current Procedural Terminology codes, and associated charges. They also used the drugs’ prescribing information and medication guides to determine specific monitoring and administration recommendations. In addition, the authors assumed that 95% of patients with MS were treated with immunomodulators, the therapies were initiated based on market share in the United States, and patients remained on the same therapy for 1 year. The market share was 37.4% for glatiramer acetate, 22.2% for interferon beta-1a intramuscular injection, 16.3% for interferon beta-1a subcutaneous injection, 11.8% for interferon beta-1b subcutaneous injection, 10.6% for natalizumab, and 1.7% for fingolimod. Furthermore, they analyzed a database of 46,589 patients who had MS to support their assumptions if there was no data from the prescribing information or clinical trials. They assumed a health plan of 1 million members, including 1020 with MS and 969 who received treatment for MS. For the million-member plan, the authors found that the total monitoring costs for the products in the first year was $521,516, for a per-member per-year (PMPY) cost of $0.52. There were no monitoring costs per patient and no PMPY cost for glatiramer acetate. The annual monitoring costs per patient and the PMPY cost were $269 and $0.06 for interferon beta-1a intramuscular injection; $335 and $0.05 for interferon beta-1a subcutaneous injection; $399 and $0.05 for interferon beta-1b subcutaneous injection; $1756 and $0.03 for fingolimod; and $3273 and $0.34 for natalizumab. The study included several limitations, according to the authors. They indicated the monitoring frequency and patient proportions may not be accurate because they were limited to the prescribing information, clinical trial experiences, and/or available literature. They also said the results may not be consistent for all MS patient populations because the study was retrospective. In addition, the tool did not include the cost of the drugs and did not account for monitoring and administration costs past the first year as well as costs associated with switching or reinitiating treatment. This study was supported by Teva Pharmaceuticals.