TABLE 4.
Total Cost per Patient, Relapses Avoided, Cost per Relapse Avoided and ICERs for Models 1 and 2
| Model 1: PEG | Model: 2 ALT | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| PEG | IM IFN beta-1a | SC IFN beta-1b | GA | FIN | NAT | DMF | ALT | IFN beta-1a 44 μg | |
| DMT cost ($) | 65,442 | 65,442 | 45,637 | 74,548 | 71,141 | 64,480 | 66,248 | 158,000 | 141,276 |
| Administration + monitoring + utilization cost ($) | 340 | 364 | 340 | 296 | 802 | 2,331 | 307 | 3,438 | 810 |
| Treatment of relapses ($)a | 776 | 998 | 798 | 865 | 554 | 421 | 576 | 1,153 | 2,306 |
| Total cost ($) | 66,558 | 66,804 | 46,775 | 75,710 | 72,761 | 67,232 | 67,131 | 162,591 | 144,392 |
| Relapse avoided per patient | 0.20 | 0.10 | 0.19 | 0.16 | 0.30 | 0.36 | 0.29 | 1.18 | 0.46 |
| Cost per relapse avoided ($) | 332,790 | 668,040 | 246,184 | 473,188 | 242,537 | 186,756 | 231,486 | 137,789 | 313,896 |
| ICER ($)b CostA–CostB ÷ Number of relapses avoidedA–Number of relapses avoidedB |
– | PEG dominated | PEG vs. SC IFN beta-1b: $1,978,000 |
PEG dominated | FIN vs. PEG: 62,030c |
NAT vs. PEG: 4,213c |
DMF vs. PEG: 6,367c |
– | ALT vs. IFN beta-1a 44 μg: $25,276 |
Note: All costs are reported per person in 2015 U.S. dollars.
aCost for relapse treatment was calculated as a product of number of relapses elapses after DMT treatment and cost of treating 1 relapse. Cost of treating relapse was extracted from literature (inflated to 2015 dollars: $2,217).7
bCostA and CostB for Model 1: A = PEG; B = IM IFN, SC IFN, GA, FIN, NAT, and DMF; for Model 2, A = ALT; B = IFN beta-1a 44 μg.
cICERs for FIN, NAT, and DMF are compared with PEG, since these 3 DMTs cost more and were more effective than PEG.
ALT = alemtuzumab; DMF = dimethyl fumarate; DMT = disease-modifying therapy; FIN = fingolimod; GA = glatiramer acetate; ICER = incremental cost-effectiveness ratio; IFN = interferon; IM = intramuscular; NAT = natalizumab; PEG = peginterferon beta-1a; SC = subcutaneous.