Cost-effectiveness of oral versus injectable disease modifying therapies in relapsing multiple sclerosis: a systematic review analysis.
Humans
Cost-Benefit Analysis
Administration, Oral
Fingolimod Hydrochloride
/ therapeutic use
Multiple Sclerosis, Relapsing-Remitting
/ drug therapy
Crotonates
/ therapeutic use
Hydroxybutyrates
Injections
Toluidines
/ therapeutic use
Nitriles
/ economics
Immunosuppressive Agents
/ economics
Interferon beta-1a
/ therapeutic use
Alemtuzumab
/ administration & dosage
Cost-utility
Economic evaluation
Incremental net monetary benefit (INMB)
Injectable drugs
Multiple sclerosis
Oral drugs
Quality adjusted life years (QALY)
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
28 Oct 2024
28 Oct 2024
Historique:
received:
21
10
2023
accepted:
21
10
2024
medline:
29
10
2024
pubmed:
29
10
2024
entrez:
29
10
2024
Statut:
epublish
Résumé
Multiple sclerosis (MS) is a chronic and progressive neurological autoimmune disease that affects the central nervous system. There are two types of drugs used to treat this disease: injectable and oral drugs. The present study aimed at systematically reviewing the cost effectiveness of oral versus injectable drugs. The researchers searched the PubMed, Scopus, and Web of Science databases to find relevant studies. After removing the duplicates, two authors independently assessed the records. The studies that had conducted full economic evaluations of oral versus injectable drugs in MS patients were included. The Quality of Health Economic Studies (QHES) tool was also used to assess the quality of the studies. Thirty studies that had conducted the economic analysis of oral versus injectable therapies in MS patients were included in this review. The QHES scores for all records were generally high (≥ 77) and they were of good quality. The lowest and highest levels of incremental net monetary benefit were respectively obtained through the comparison of Fingolimod and Alemtuzumab (-1,419,333) and the comparison of Teriflunomide and Interferon β-1a (1,792,810). The amount of INMB (incremental net monetary benefit) in the comparisons between oral and injectable drugs showed that the highest and lowest amount of INMB calculated between) Fingolimod and injectable drugs, respectively, compared to (interferon β-1a) 98,253 and (Ocrelizumab) -212,417, the highest amount in dimethyl fumarate is also against (peginterferon β-1a) 191,470 and the lowest against (alemtuzumab) -124,333, Teriflunomide against injectable drugs is the highest against (peginterferon β-1a) 89,956 and the lowest (Ocrelizumab) - 194,169, as well as Cladribine compared to injectable drugs, the highest was compared to (interferon β-1a) 236,430 and the lowest (Ocrelizumab) was 23,965. A large number of health economic evaluations of disease-modifying therapies (DMTs) in MS were available at the international level, the comparison of which was difficult and sometimes contradictory. However, despite the difference in the results, Cladribine tablets were cost-effective in all studies compared with injectable drugs. In addition, the present study could be of great importance for policymakers and other beneficiaries regarding the cost-effectiveness of the aforementioned drugs.
Sections du résumé
BACKGROUND
BACKGROUND
Multiple sclerosis (MS) is a chronic and progressive neurological autoimmune disease that affects the central nervous system. There are two types of drugs used to treat this disease: injectable and oral drugs. The present study aimed at systematically reviewing the cost effectiveness of oral versus injectable drugs.
METHODS
METHODS
The researchers searched the PubMed, Scopus, and Web of Science databases to find relevant studies. After removing the duplicates, two authors independently assessed the records. The studies that had conducted full economic evaluations of oral versus injectable drugs in MS patients were included. The Quality of Health Economic Studies (QHES) tool was also used to assess the quality of the studies.
RESULTS
RESULTS
Thirty studies that had conducted the economic analysis of oral versus injectable therapies in MS patients were included in this review. The QHES scores for all records were generally high (≥ 77) and they were of good quality. The lowest and highest levels of incremental net monetary benefit were respectively obtained through the comparison of Fingolimod and Alemtuzumab (-1,419,333) and the comparison of Teriflunomide and Interferon β-1a (1,792,810). The amount of INMB (incremental net monetary benefit) in the comparisons between oral and injectable drugs showed that the highest and lowest amount of INMB calculated between) Fingolimod and injectable drugs, respectively, compared to (interferon β-1a) 98,253 and (Ocrelizumab) -212,417, the highest amount in dimethyl fumarate is also against (peginterferon β-1a) 191,470 and the lowest against (alemtuzumab) -124,333, Teriflunomide against injectable drugs is the highest against (peginterferon β-1a) 89,956 and the lowest (Ocrelizumab) - 194,169, as well as Cladribine compared to injectable drugs, the highest was compared to (interferon β-1a) 236,430 and the lowest (Ocrelizumab) was 23,965.
CONCLUSION
CONCLUSIONS
A large number of health economic evaluations of disease-modifying therapies (DMTs) in MS were available at the international level, the comparison of which was difficult and sometimes contradictory. However, despite the difference in the results, Cladribine tablets were cost-effective in all studies compared with injectable drugs. In addition, the present study could be of great importance for policymakers and other beneficiaries regarding the cost-effectiveness of the aforementioned drugs.
Identifiants
pubmed: 39468560
doi: 10.1186/s12913-024-11800-8
pii: 10.1186/s12913-024-11800-8
doi:
Substances chimiques
Fingolimod Hydrochloride
G926EC510T
teriflunomide
1C058IKG3B
Crotonates
0
Hydroxybutyrates
0
Toluidines
0
Nitriles
0
Immunosuppressive Agents
0
Interferon beta-1a
XRO4566Q4R
Alemtuzumab
3A189DH42V
Types de publication
Journal Article
Systematic Review
Review
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1288Subventions
Organisme : Abdosaleh Jafari
ID : 93-01-68-7592
Organisme : Abdosaleh Jafari
ID : 93-01-68-7592
Organisme : Abdosaleh Jafari
ID : 93-01-68-7592
Organisme : Abdosaleh Jafari
ID : 93-01-68-7592
Informations de copyright
© 2024. The Author(s).
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