Highlights
- •We analyse the cost effectiveness of routine NAb testing versus no testing in MS patients.
- •We develop a Markov model over five years, which reconstructs the clinical pathway and includes disease progression, relapse, treatment switch, etc.
- •Austrian cost data were used.
- •Model results suggest that NAb testing avoids ineffective treatment, reduces relapses and associated costs.
Abstract
Background
According to EU-guidelines testing patients on interferon-beta (IFNb) for the presence
of neutralising antibodies (NAb) is recommended; IFNb treatment efficacy of NAb-positive
patients equals that of placebo-treated patients. Economic impact of NAb testing in
MS patients has not been explored yet. The aim of this analysis is to estimate the
impact of NAb testing in RRMS-patients on Austria׳s health-care-system.
Methods
A decision-analytic model over 5 years was performed. The cost effectiveness of NAb
testing versus no testing was evaluated. The model considers switching after relapse
and withdrawal. All direct costs are based on Austrian data from 2013 and were discounted
at 5% per year. The efficacy outcome measure was “relapse free”. Clinical data and
resource use were determined by literature.
Results
Total costs for all Austrian MS-patients on IFNb-therapy with testing amount to 187,554,021€
over 5 years; without testing is 175,091,300 €. Costs per relapse avoided over 5 years
were 90,075€ in the NAb testing arm, and 99,535€ in the no NAb test arm, resulting
in a difference of 9460€ in favour of routine NAb testing. Considering all 3590 IFNb-treated
patients 2082 relapses can be avoided in the NAb testing arm versus 1759 in the no-testing
arm within 5 years. Testing for NAb leads to costs per relapse avoided of 18,015€
per year versus 19,907€ when no tests are done.
Conclusion
The results suggest that NAb testing reduces relapses and associated costs.
Keywords
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Article info
Publication history
Published online: September 14, 2014
Accepted:
September 2,
2014
Received in revised form:
August 26,
2014
Received:
March 27,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
