March 6, 2003
The cost-effectiveness of treating multiple sclerosis with modern drugs is low in the short term but improves significantly over a 20-year period, British researchers said on Thursday.
But, they add, the real cost-benefit relationship is impossible to determine because little long-term data is available, at least in the public arena.
"That 'but' is absolutely huge," said health economics lecturer Chris McCabe from the University of Sheffield, whose group modelled the benefits of four drugs for Britain's National Institute for Clinical Excellence (NICE).
"The model predicts out to 20 years, but by about 10 years the vast majority of patients will no longer be receiving therapy -- either the patient stops for their own reasons or clinically the therapy is stopped." The researchers looked at three interferon beta drugs -- Biogen Inc (NASDAQ: BGEN - news) 's Avonex, Schering AG (Xetra: 717200.DE - news) 's Betaferon and Serono SA (Virt-X: SEOZ.VX - news) 's Rebif -- together with Teva Pharmaceutical Industries Ltd's Copaxone.
Using the 20-year time horizon, the cost per quality adjusted life year (QALY) gained by using the drugs ranged from 42,000 pounds to 98,000 pounds, researchers reported in the British Medical Journal.
QALYs combine the life-enhancing and life-extending properties of medical interventions into one measurement.
Beta interferons and Copaxone are used in many countries to slow disease progression, but in Britain most patients have been denied the drugs following controversy over their long-term effectiveness and cost.
Last year, the Department of Health agreed a "risk-sharing" scheme with
drug firms, under which the government will continue payments for the drugs
if they prove effective. If not, payments to firms supplying the medicines
will reduce on a sliding scale.
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