Tuesday, March 11, 2003
By Health Newswire reporters
The cost of disease-modifying drug treatments for multiple sclerosis (MS) is high, but decreases with prolonged treatment up to 20 years, according to a recent UK study.
A team of researchers from universities in Sheffield, Leicester and York says the cost per quality-adjusted life year is unlikely to be less than £40,000.
Dr Jim Chilcott and colleagues evaluated the cost effectiveness of four drugs – three interferon betas and glatiramer acetate – currently licensed for the treatment of relapsing remitting and secondary progressive MS in the UK.
They assessed the effect of each drug compared with conventional management (including symptom control, physiotherapy and psychiatric support) over 20 years using the best available evidence.
Reporting in the British Medical Journal, the team found that the cost of each year of life saved or prolonged by using any of the four drugs ranged from £42,000 to £98,000.
The main determinants of cost effectiveness were the price of the drugs, different discount rates, the progression of patients after stopping treatment and the time horizon.
Dr Chilcott’s team cautions, however, that there is “substantial uncertainty” surrounding these cost estimates.
“This uncertainty could be reduced by conducting research on the true magnitude of the effect of these drugs, the progression of patients after stopping treatment, the costs of care and the quality of life of the patients,” the researchers conclude.
In an accompanying commentary, Professor David Miller, a clinical neurologist from the Institute of Neurology and the National Hospital for Neurology and Neurosurgery in London, says research is needed to identify those who will benefit most from disease-modifying treatments.
He notes that the Department of Health has introduced a risk-sharing scheme for providing these treatments in the NHS. He says that although the scheme would need substantial investment, it is hard to see a realistic alternative.
Reference: Chilcott et al, British Medical Journal 2003;326:522-525
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