Medical Department, TEVA Pharmaceutical, Calle de Anabel Segura, 11, 28108, Madrid, Spain.
Market Access & Regulatory Department, TEVA Pharmaceutical, Calle de Anabel Segura, 11, 28108, Madrid, Spain.
Health Econ Rev. 2015 Dec;5(1):30. doi: 10.1186/s13561-015-0066-2. Epub 2015 Oct 16.
The Escala Study evidenced that the administration of glatiramer acetate for relapsing-remitting multiple sclerosis improved the spasticity of patients previously treated with interferon-β. However, whether such an improvement was translated into cost savings remained unclear. We therefore conducted a cost analysis of glatiramer acetate versus interferon-β in these patients with multiple sclerosis and spasticity.
This cost analysis encompassed data from the observational Escala Study, which included patients with relapsing-remitting multiple sclerosis and spasticity whose treatment had been switched from interferon-β to glatiramer acetate. Costs prior to starting glatiramer acetate (interferon-β period) were compared to the subsequent six months on glatiramer acetate (glatiramer acetate period). The analysis was carried out following the recommendations for conducting pharmacoeconomic studies and from the Spanish National Health System perspective. Costs associated with multiple sclerosis treatment, spasticity treatment and relapse management were expressed in 2014 euros (€); a 7.5 % discount was applied-when needed-as stipulated in Spanish law.
The management of relapsing-remitting multiple sclerosis, spasticity and relapses accounted for a 6-month cost per patient of 7,078.02€ when using interferon-β and 4,671.31€ when using glatiramer acetate. Switching from interferon-β to glatiramer acetate therefore represented a cost saving of 2,406.72€ per patient in favour of glatiramer acetate, which resulted from savings in treatment costs, relapse management and spasticity treatment of 1,890.02€, 430.48€ and 86.21€, respectively. The ratio of the costs during interferon-β was 1.5 times the costs during glatiramer acetate; thus, a fixed budget of 5,000,000€ would enable 1,070 patients to be treated with glatiramer acetate and only 706 patients with interferon-β.
The treatment of relapsing-remitting multiple sclerosis with glatiramer acetate entailed cost savings when compared to interferon-β in patients with spasticity, which not only resulted from its lower costs of therapy and relapse management but also from its favourable effect on reducing spasticity. Thus, glatiramer acetate may be regarded as a more efficient alternative than interferon-β from the perspective of the Spanish National Health System.
Escala 研究表明，对于复发缓解型多发性硬化症患者，使用醋酸格拉替雷治疗可改善先前接受干扰素-β治疗的患者的痉挛症状。然而，这种改善是否能转化为成本节约尚不清楚。因此，我们对患有多发性硬化症和痉挛的患者中醋酸格拉替雷与干扰素-β进行了成本分析。
本成本分析包括观察性 Escala 研究的数据，该研究纳入了接受过干扰素-β治疗后转为醋酸格拉替雷治疗的复发缓解型多发性硬化症和痉挛患者。在开始使用醋酸格拉替雷之前（干扰素-β期）的成本与随后的六个月使用醋酸格拉替雷（醋酸格拉替雷期）的成本进行了比较。该分析按照进行药物经济学研究的建议，并从西班牙国家卫生系统的角度进行。与多发性硬化症治疗、痉挛治疗和复发管理相关的成本以 2014 年欧元（€）表示；根据西班牙法律规定，当需要时，应用了 7.5%的折扣。
使用干扰素-β时，每位患者 6 个月的复发缓解型多发性硬化症、痉挛和复发管理成本为 7078.02 欧元，而使用醋酸格拉替雷时为 4671.31 欧元。因此，从干扰素-β转为醋酸格拉替雷可使每位患者节省 2406.72 欧元，有利于醋酸格拉替雷，这是由于治疗成本、复发管理和痉挛治疗分别节省了 1890.02 欧元、430.48 欧元和 86.21 欧元。使用干扰素-β的成本是使用醋酸格拉替雷的成本的 1.5 倍；因此，如果固定预算为 500 万欧元，则可以使用醋酸格拉替雷治疗 1070 名患者，而仅能使用干扰素-β治疗 706 名患者。
对于患有痉挛的复发缓解型多发性硬化症患者，与干扰素-β相比，使用醋酸格拉替雷治疗可节约成本，这不仅源于其治疗和复发管理成本较低，还源于其对减轻痉挛的有利影响。因此，从西班牙国家卫生系统的角度来看，醋酸格拉替雷可能是一种比干扰素-β更有效的替代方案。
