New Study on Cost Effectiveness of MS Therapies
Summary
A new study co-funded by the National MS Society (USA), the
National Institutes of Health and the University of Rochester
examined the cost-effectiveness of therapies to treat MS, and
found that the cost for improving the quality of life for people
with MS in the U.S. is high. The study found that the earlier
disease-modifying therapies were used, the more cost-effective
they were, adding to growing evidence suggesting that treating MS
early and consistently is the best way to ward off future disease
activity. [Katia Noyes, PhD, MPH, and colleagues from the
University of Rochester, New York. Neurology, published online
July 20, 2011].
Details
Researchers from the University of Rochester, New York, analyzed
data from 844 people with relapsing MS to estimate disease
progression over a 10-year period. Data included health care
costs, lost work time and other factors, and their use of
disease-modifying MS therapies. The study determined how
treatment affected quality-adjusted life years (QALY). QALY is a
health-research measure which looks at quantity and quality of
life, taking in to consideration therapeutic impacts as well as
impacts such as disability-related unemployment. In this
study, QALY allowed investigators to assess the efficacy of
disease-modifying treatments in terms of impact on quality of
life.
Cost-effectiveness studies analyze quality of life as it relates
to health and examine what costs are involved in improving
health-related quality of life.
Results indicated that disease-modifying therapies benefit people
with MS although the extent of improvement in quality-adjusted
life years provides modest benefits at a high cost on an overall
basis. While they do not work for everyone, for many individuals,
disease-modifying therapies have profoundly enhanced their
ability to stay active and productive. In addition, starting
disease-modifying therapy earlier was associated with greater
health gains and better overall cost-effectiveness.
The study was not a clinical trial and did not measure whether
the therapies altered disease progression leading to a higher
level of disability. Further research is required to understand
the long-term effects of MS therapies and their benefits on
disease progression.
The management of MS has advanced considerably with the
availability of disease-modifying agents. In the United States
the first therapy was approved in 1993 and 1995 in Canada. Over
the years, evidence from clinical trials and prescription use has
shown their effectiveness in reducing the number and severity of
MS relapses (reducing relapses by approximately one third to one
half) and slowing disease progression. There are currently seven
disease-modifying therapies approved in Canada ranging in cost
from $20,000 - $40,000 per year (cost to individuals without
private or public insurance coverage).
Although the majority of Canadians with MS who use disease
modifying therapies have most of the cost reimbursed by private
insurance plans and/or public drug programs, there are still
gaps. The MS Society continues to urge federal, provincial and
territorial governments to work together to develop an overall
strategy that ensures Canadians have access to all Health
Canada-approved drugs and to increase funding for costly drugs so
Canadians need not spend more than three per cent of family
income on prescription medications.
The preceding MS Update contains information from the National MS
Society.