Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Mar 8;326(7388):522; discussion 522.
doi: 10.1136/bmj.326.7388.522.

Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis. Commentary: evaluating disease modifying treatments in multiple sclerosis

Jim Chilcott  1 , Chris McCabe, Paul Tappenden, Anthony O'Hagan, Nicola J Cooper, Keith Abrams, Karl Claxton, David H Miller; Cost Effectiveness of Multiple Sclerosis Therapies Study Group
Affiliations

Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis. Commentary: evaluating disease modifying treatments in multiple sclerosis

Jim Chilcott et al. BMJ. .

Abstract

Objective: To evaluate the cost effectiveness of four disease modifying treatments (interferon betas and glatiramer acetate) for relapsing remitting and secondary progressive multiple sclerosis in the United Kingdom.

Design: Modelling cost effectiveness.

Setting: UK NHS.

Participants: Patients with relapsing remitting multiple sclerosis and secondary progressive multiple sclerosis.

Main outcome measures: Cost per quality adjusted life year gained.

Results: The base case cost per quality adjusted life year gained by using any of the four treatments ranged from pound 42,000 (66,469 dollars; 61,630 euro) to pound 98,000 based on efficacy information in the public domain. Uncertainty analysis suggests that the probability of any of these treatments having a cost effectiveness better than pound 20,000 at 20 years is below 20%. The key determinants of cost effectiveness were the time horizon, the progression of patients after stopping treatment, differential discount rates, and the price of the treatments.

Conclusions: Cost effectiveness varied markedly between the interventions. Uncertainty around point estimates was substantial. This uncertainty could be reduced by conducting research on the true magnitude of the effect of these drugs, the progression of patients after stopping treatment, the costs of care, and the quality of life of the patients. Price was the key modifiable determinant of the cost effectiveness of these treatments.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Model of transitions between health states of patients with relapsing remitting or secondary progressive multiple sclerosis
Figure 2
Figure 2
Cost effectiveness acceptability curves for four treatments for multiple sclerosis over 20 year time horizon
Figure 3
Figure 3
Impact of time horizon on cost effectiveness
See this image and copyright information in PMC

References

    1. Compston A, Ebers G, Lassmann H, McDonald I, Matthews B, Wekerle H. McAlpine's multiple sclerosis. Edinburgh: Churchill Livingstone; 1998. Natural history of multiple sclerosis; pp. 191–221.
    1. Richards RG, Sampson FC, Beard SM, Tappenden P. A review of the natural history and epidemiology of multiple sclerosis: implications for resource allocation and health economic models. Health Technol Assess. 2002;6(10):i-73. - PubMed
    1. Association of British Neurologists. Guidelines for treatment with interferon beta and glatiramer acetate in multiple sclerosis. London: ABN; 2001.
    1. Parkin D, McNamee P, Jacoby A, Miller P, Thomas S, Bates D. A cost-utility analysis of interferon beta for multiple sclerosis. Health Technol Assess. 1998;2(4):i-58. - PubMed
    1. Brown MG, Murray TJ, Sketris IS, Fisk JD, LeBlanc JC, Schwartz CE, et al. Cost-effectiveness of interferon beta-1b in slowing multiple sclerosis disability progression. First estimates. Int J Technol Assess Health Care. 2000;16:751–767. - PubMed

Publication types

MeSH terms