Highlights
- •There are now over a dozen DMTs available to treat MS.
- •The literature on the cost effectiveness of DMTs is often confusing and contradictory.
- •Currently, the drugs with the most benefit tend to be those that carry the most risk and highest price tag.
- •CEAs support the idea that using more aggressive measures earlier on may mean the cost of long term disability is reduced.
Abstract
There are now over a dozen disease modifying therapies (DMTs) available to treat multiple
sclerosis (MS). They vary in efficacy and safety as well as in cost.
The literature on the cost effectiveness of these is often confusing and contradictory.
There is a lack of quality evidence enabling the comparison of different DMTs. There
are scarce randomized controlled trials which look at one DMT compared with another
that is not IFN or GA. There is also a lack of systematic reviews comparing the efficacy
and safety of different DMTs. This makes it difficult to perform good quality cost-effectiveness
analyses (CEAs). Furthermore, CEAs in and of themselves are difficult to interpret
or compare due to the variation in methods and cost estimations as well as the use
of outcome measures which cannot be proven over a reasonable timeframe.
This review looks at the different DMTs available for MS and attempts to draw some
conclusions on their cost-effectiveness. It also considers the costs and benefits
of front loading the cost of treatment for MS by using more expensive and effective
treatment earlier on.
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Article info
Publication history
Published online: July 09, 2019
Accepted:
July 9,
2019
Received in revised form:
July 3,
2019
Received:
November 5,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
