Table.

Base case analysis for estimates of cost per QALY from Sheffield model^*

Trial	Type of multiple sclerosis	Current cost/patient/year (£)†	Estimates of treatment effect from published data			Cost per QALY gained (£)
			Relative relapse rate	Relative hazard rate for disability progression		Published data 20 years	Published plus confidential commercial data‡
							20 years	10 years	5 years
Intramuscular interferon beta-1-a11 12	Relapsing-remitting	9 061	0.82	0.54		48 000	106 000	618 000	783 000
Subcutaneous interferon beta-1-a 22 μg13	Relapsing-remitting	9 088	0.71	0.64		59 000	59 000	325 000	511 000
Subcutaneous interferon beta-1-a 44 μg13	Relapsing-remitting	12 068	0.67	0.62		79 000	79 000	406 000	638 000
Subcutaneous interferon beta-1-b 8 MIU910	Relapsing- remitting	7 259	0.71	0.71		52 000	39 000	226 000	365 000
Subcutaneous interferon beta-1-b 8 MIU15	Relapsing-remitting, secondary progressive	7 259	0.69	0.72		41 000	43 000	230 000	380 000
Subcutaneous glatiramer21 22	Relapsing-remitting	6 650	0.71	0.76		98 000	98 000	442 000	443 000

^* This assumes that patients are treated according to the Association of British Neurologists criteria for starting and stopping treatment; the mean age of patients at the start of treatment is 30 years; costs are discounted at 6% per year and quality of life benefits at 1.5% per year; 10% of patients will withdraw from treatment during each of the first two years and 3% per year thereafter. The model allows for variation in these assumptions, in the costs and treatment effects shown in the table above and in other factors (costs of multiple sclerosis related disability and relapses, and the utilities associated with various disability states, relapses, and treatment side effects). Some important examples are: (a) if the discount rate for future benefits is increased from 1.5% to 6% annually, the costs per QALY gained roughly double; (b) if the model assumes that nobody stops treatment prematurely, the costs per QALY gained increase further by up to a third. 

^†Costs are those quoted in the NICE and Sheffield reports and used in the cost effectiveness analyses summarised here. Note that for the risk sharing scheme, the Department of Health has stated that the annual costs are interferon beta-1-a £8502, interferon beta-1-a 22 μg £7513, Interferon beta-1-a 44 μg £8942, interferon beta-1-b 8 MIU £7259, glatiramer £5823. 

^‡Additional data were available from only Biogen^{11 12} and Schering.^{9 10 15} The nature of these data is not clear from the Sheffield report.