Cost-Effectiveness of Oral Agents in Relapsing-Remitting Multiple Sclerosis Compared to Interferon-Based Therapy in Saudi Arabia

摘要

Multiple sclerosis (MS) is a disabling neurologic disease characterized by chronic inflammation and demyelination of the central nervous system (CNS).1 MS affects predominately patients aged 20--40 years. In recent years, there has been considerable innovation and scientific progress made in the treatment of relapsing-remitting multiple sclerosis (RRMS), a subtype of MS that affects approximately 90% patients of MS patients. As a result of these advancements, three new oral disease modifying drugs (DMDs) namely Fingolimod (GilenyaRTM), Teriflunomide (AubagioRTM), and Dimethyl fumarate (TecfideraRTM) were approved by the FDA in 2010, 2012, and 2013, respectively. Clinical trials and new evidence have shown that these new agents are accompanied with high efficacy and relatively safe compared to Interferon-beta (IFN-beta) therapy. However, there are few head-to head studies that have compared oral agents with conventional treatments especially in Middle Eastern countries. In addition, doubts have been expressed about the effectiveness of these treatments, which have compounded the problems associated with estimating the relative cost effectiveness of such interventions. For these reasons, we performed a cost-effectiveness analysis to determine which treatment option is appropriate for Saudi population. To date, this is considered the first CEA to use real-world cost data and offer a comprehensive comparison between the new oral DMDs from a Saudi healthcare payers' (KFSH&RC) perspective.