Alemtuzumab Shows Cost Savings in 5-Year Treatment Scenario

Treatment with alemtuzumab (Lemtrada, Genzyme) for relapsing-remitting multiple sclerosis (RRMS) demonstrated a cost savings compared with subcutaneous interferonß-1a due to cost avoidance in relapse reduction and drug cost associated with alemtuzumab’s persistent efficacy over 5 years after initiation of therapy in the absence of retreatment for the majority of patients, according to new research presented in a poster at AMCP.

To assess potential cost savings using a payer perspective, the researcher constructed a cost model with results from the CARE MS II study attributing direct costs of alemtuzumab and interferonß-1a, adverse effects, monitoring, and relapse. A hypothetical 2,500,000 beneficiary population was used to determine the cost of treatment for patients with RRMS receiving alemtuzumab or interferonß-1a exclusively.

Total treatment cost of 3 RRMS population in year 1 of the model was higher for alemtuzumab than with interferonß-1a ($396,046,399 vs $282,310,834, respectively). Costs decreased over the next 4 years, resulting in savings of $25,452,716, $150,775,000, $210,895,144, and $231,561,444 in years 2, 3, 4, and 5, respectively. The total relapse cost per year was significantly less in the alemtuzumab group compared with the interferonß-1a group ($4,802,502 vs $9,603,494, respectively). However, adverse effect costs per year were lower in the interferonß-1a group than in the alemtuzumab group ($454,197 vs $1,010,401, respectively). Within the hypothetical beneficiary population, alemtuzumab therapy resulted in a per member per month savings of $0.85, $5.03, $7.03, and $7.72 in years 2, 3, 4, and 5, respectively.

“The cost-savings estimate of alemtuzumab may be conservative as the reduction of disability associated with its use was not considered in this analysis,” noted the study author.

CARE-MS II was a 2-year, randomized, open-label, rater-blinded, phase III study of patients with RRMS who had an inadequate response to prior therapy. The study showed that alemtuzumab had superior efficacy over interferonß-1a and manageable safety over 2 years. The 3-year follow-up to the core study showed that more than half of these patients (59.8%) received only the initial 2 annual treatment courses at 0 month and 12 months.—Eileen Koutnik-Fotopoulos

This study was supported by funding from Sanofi Genzyme BioVentures; Bayer Pharma AG.

Wandstrat T. Potential cost savings due to alemtuzumab persistent reduction in disease endpoints through 5 years without retreatment for majority of patients. J Manag Care Spec Pharm. 2016;22(4 suppl):S73.