A clinical-economic evaluation of alemtuzumab in relapsing-remitting multiple sclerosis

Aim

Evaluation of economic appropriateness of alemtuzumab inclusion into the Governmental high cost drugs’ reimbursement program (“7 Nosologies”) in highly active relapsing-remitting multiple sclerosis.

Material and methods

We conducted a retrospective comparative analysis of published data using widely accepted pharmacoeconomics methods, i.e. cost-effective analysis, budget impact analysis, and cost-utility analysis.

Results

An average cost for alemtuzumab treatment within 6-years horizon is less compared with natalizumab by 34,3% (440 thousands RUR). Natalizumab substitution for alemtuzumab within the frame of the “7 Nosologies” program can decrease budget expenditures from the 4th year of therapy. At 6 years, total cost savings can reach at least 2.05 bln RUR for the target group of patients (34.4%) while the total quantity of treated patients can increase by 63.6%. Average decrease in annual cost per patient would be 38.9%, or 780 thousands RUR. Maximal economic efficacy with alemtuzumab is expected after 6 years of therapy. Cost-utility analysis has shown that the cost per one QALY gained for alemtuzumab was less by 44.9% compared with natalizumab. Sensitivity analysis has demonstrated the stability of results with cost volatility for alemtuzumab up to 50%.

Conclusion

Alemtuzumab inclusion into “7 Nosologies” reimbursement program is justified from pharmacoeconomic point of view.

Key words

Clinical-economic analysis, multiple sclerosis, alemtuzumab, natalizumab.