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. 2023 Feb;12(2):e220193.
doi: 10.2217/cer-2022-0193. Epub 2023 Jan 27.

Cost-effectiveness of cladribine tablets and dimethyl fumarate in the treatment of relapsing remitting multiple sclerosis in Spain

Ricardo Ginestal  1 , Carlos Rubio-Terrés  2 , Olga Durán Morán  3 , Darío Rubio-Rodríguez  2 , Heidi De Los Santos  3 , Cristina Ordoñez  3 , Isabel Sánchez-Magro  3
Affiliations

Cost-effectiveness of cladribine tablets and dimethyl fumarate in the treatment of relapsing remitting multiple sclerosis in Spain

Ricardo Ginestal et al. J Comp Eff Res. 2023 Feb.

Abstract

Aim: To analyze the cost-effectiveness of treatment of relapsing remitting multiple sclerosis (RRMS) with cladribine tablets (CladT) and dimethyl fumarate (DMF) from the perspective of the Spanish National Health System (NHS). Methods: A probabilistic Markov model (second-order Monte Carlo simulation) with a 10-year time horizon and annual Markov cycles was performed. Results: CladT was the dominant treatment, with lower costs (-74,741 € [95% CI: -67,247; -85,661 €]) and greater effectiveness (0.1920 [95% CI: -0.1659; 0.2173] QALY) per patient, compared with DMF. CladT had a 95.1% probability of being cost-effective and a 94.1% chance of being dominant compared with DMF. Conclusion: CladT is the dominant treatment (lower costs, with more QALYs) compared with DMF in the treatment of RRMS in Spain.

Keywords: cladribine tablets; cost–effectiveness; dimethyl fumarate; multiple sclerosis; relapsing-remitting multiple sclerosis.

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Conflict of interest statement

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.

Figures

Figure 1.
Figure 1.. Five-state Markov model, adapted from a model of the Canadian Agency for Drugs and Technologies in Health and the Norwegian Institute of Public Health [16,18].
Patients with relapsing remitting multiple sclerosis. EDSS: Expanded Disability Status Scale.
Figure 2.
Figure 2.. Incremental cost–effectiveness plane of cladribine tablets versus dimethyl fumarate.
EUR: Euros; ICE: Incremental cost–effectiveness ratio; QALY: Quality-adjusted life years; WTP: Willingness to pay to gain one QALY: 25,000 €.
See this image and copyright information in PMC

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