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Cost-Effectiveness Analysis of Ocrelizumab for the Treatment of Relapsing and Primary Progressive Multiple Sclerosis in Portugal

dc.contributor.authorMartins, P
dc.contributor.authorVandewalle, B
dc.contributor.authorFélix, J
dc.contributor.authorCapela, C
dc.contributor.authorCerqueira, JJ
dc.contributor.authorSalgado, AV
dc.contributor.authorFerreira, DG
dc.contributor.authorMonteiro, I
dc.date.accessioned2023-04-12T14:53:52Z
dc.date.available2023-04-12T14:53:52Z
dc.date.issued2023
dc.description.abstractObjectives: Ocrelizumab demonstrated significant clinical benefit for the treatment of relapsing (RMS) and primary progressive (PPMS) multiple sclerosis (MS), an incurable disease characterized by disability progression. This study evaluated the clinical and economic impact of ocrelizumab relative to current clinical practice, including other disease-modifying therapies (DMT), available in Portugal. Methods: Markov models for MS were adapted to estimate the impact of ocrelizumab across three patient populations: treatment-naïve RMS, previously treated RMS, and PPMS. Health states were defined according to the Expanded Disability Status Scale. For RMS, the model further captured the occurrence of relapses and progression to secondary progressive multiple sclerosis (SPMS). A lifetime time-horizon and Portuguese societal perspective were adopted. Results: For RMS patients, ocrelizumab was estimated to maximize the expected time (years) without progression to SPMS (10.50) relative to natalizumab (10.10), dimethyl fumarate (8.64), teriflunomide (8.39), fingolimod (8.38), interferon β-1a (8.33) and glatiramer acetate (8.18). As the most effective option, with quality-adjusted life year (QALY) gains between 0.3 and 1.2, ocrelizumab was found to be cost-saving relative to natalizumab and fingolimod, and presented incremental cost-effectiveness ratios (ICER) below €16,720/QALY relative to the remaining DMT. For PPMS patients, the ICER of ocrelizumab versus best supportive care was estimated at €78,858/QALY. Conclusions: Ocrelizumab provides important health benefits for RMS and PPMS patients, comparing favourably with other widely used therapies. In RMS, ocrelizumab was revealed to be either cost-saving or have costs-per-QALY likely below commonly accepted cost-effectiveness thresholds. In PPMS, ocrelizumab fills a clear clinical gap in the current clinical practice. Overall, ocrelizumab is expected to provide good value for money in addressing the need of MS patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPharmacoecon Open . 2023 Mar;7(2):229-241pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4482
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerlinkpt_PT
dc.subjectOcrelizumabpt_PT
dc.subjectMultiple Sclerosispt_PT
dc.subjectPortugalpt_PT
dc.subjectHSAC NEUpt_PT
dc.titleCost-Effectiveness Analysis of Ocrelizumab for the Treatment of Relapsing and Primary Progressive Multiple Sclerosis in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage241pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage229pt_PT
oaire.citation.volume7pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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