Medina-Redondo F, Herrera-Carranza J, Sanabria C, Navarro G, García-Moreno J M, Gamero-García M A, Páramo M D, Ruiz-Peña J L, Izquierdo G
Servicio de Farmacia, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Rev Neurol. 2004;39(1):1-6.
The availability of the interferon beta in its three forms at the moment available in our country and of glatiramer acetate has marked a point of flexion in the natural history of multiple sclerosis (MS), but the high cost of these treatments cause that its use is questioned. In this work we have studied the effectiveness and efficiency of the processing with interferon beta, and the cost-utility of these treatments in MS in Spain has been also analyzed.
For this work we studied 102 patients affected of RR MS, treated with the three interferons beta which we have available in our country. We used as control 330 patients who had participated in the pivotal clinical interferon trials with both interferon beta 1a. In these patients in addition to effectiveness data, we have studied the disability measured as area below curve and the quality of life (AVACs). We also calculated the economical costs, considering the relation cost-utility in our country.
Besides to confirm the data of effectiveness of three interferons, in this study a saving of 23 days/year is demonstrated what corresponds to 0.063 AVACs. The additional cost of interferons is greater than the avoided cost until the fifth year of treatment in which the tendency is reversed in favor of the group of treated patients, if we assume that the same effectiveness that we found in the first years is maintained in the long term.
The use of the treatment with interferon beta is justified by its effectiveness, efficacy and efficiency. The additional cost of the treatment will be compensated in the long term if the effectiveness of the interferon beta is maintained.
我国目前可获得的三种形式的β-干扰素以及醋酸格拉替雷的出现，标志着多发性硬化症（MS）自然病程中的一个转折点，但这些治疗的高昂成本引发了对其使用的质疑。在这项研究中，我们研究了β-干扰素治疗的有效性和效率，并分析了这些治疗在西班牙MS患者中的成本效益。
在这项研究中，我们对102例复发缓解型MS患者进行了研究，这些患者接受了我国现有的三种β-干扰素治疗。我们将330例参与了β-干扰素1a关键临床试验的患者作为对照。对于这些患者，除了有效性数据外，我们还研究了以曲线下面积衡量的残疾程度和生活质量（AVACs）。我们还计算了经济成本，并考虑了我国的成本效益关系。
除了证实三种干扰素的有效性数据外，本研究还表明每年可节省23天，相当于0.063个AVACs。如果我们假设在最初几年发现的相同有效性在长期内得以维持，那么直到治疗的第五年，干扰素的额外成本才会高于避免的成本，而在第五年，趋势转向有利于治疗组。
β-干扰素治疗因其有效性、疗效和效率而具有合理性。如果β-干扰素的有效性得以维持，从长期来看，治疗的额外成本将得到补偿。
