Abstract:
AIM:Disease-modifying therapies (DMTs) impact the natural history of relapsing forms of multiple sclerosis (RRMS) by reducing annual relapse rates and slowing disability progression. The effect of DMTs on indirect costs has not been consistently explored in cost-effectiveness studies thus far. The value to patients of an emerging DMT, ocrelizumab, was quantified in comparison to subcutaneous interferon beta-1a (IFNβSC) for the prevalent RRMS population with mild-to-moderate disability in the US, based on two Phase 3 trials, OPERA I and OPERA II, of ocrelizumab vs IFNβSC in RRMS. MATERIALS AND METHODS:A Markov model was developed to compare disability progression as measured by Expanded Disability Status Scale (EDSS) and relapse outcomes over a 30-year horizon for ocrelizumab vs IFNβSC. Direct, indirect, and informal costs (2016 US dollars) and utilities for EDSS health states were obtained from the literature. Hazard ratios for disability progression and relapse rates were estimated from clinical trials. Value was assessed by calculating the net monetary benefit (NMB), defined as the monetary value of discounted quality-adjusted life years (QALYs) minus total costs, where the value of a QALY was $150,000. One-way sensitivity analyses were conducted. RESULTS:Ocrelizumab was associated with an incremental gain of 0.84 QALYs and cost savings of $287,713 relative to IFNβSC, resulting in an incremental NMB (INMB) of $413,611 per person over 30 years. The INMB increased by $151,763 for those initiating ocrelizumab at EDSS level 1 vs level 4. Influential parameters were QALY value, treatment costs, and disability progression; however, all sensitivity analyses indicated that the INMB for ocrelizumab relative to IFNβSC was ≥$300,000 per person. CONCLUSIONS:Ocrelizumab provides greater value to RRMS patients compared with IFNβSC. Initiating ocrelizumab at lower EDSS levels leads to a greater cumulative value due to slower disability progression, which extends years with higher quality-of-life.
journal_name
J Med Econjournal_title
Journal of medical economicsauthors
Frasco MA,Shih T,Incerti D,Diaz Espinosa O,Vania DK,Thomas Ndoi
10.1080/13696998.2017.1357564subject
Has Abstractpub_date
2017-10-01 00:00:00pages
1074-1082issue
10eissn
1369-6998issn
1941-837Xjournal_volume
20pub_type
杂志文章abstract:AIMS:Fast-acting insulin analogues (FAIAs) reduce hypoglycaemia and improve administration flexibility compared with short-acting human insulin (SHI). This analysis examines whether these benefits translate into cost offsets when comparing the total treatment costs for FAIA versus SHI used as basal-bolus therapy for tr...
journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.588892
更新日期:2011-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
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abstract:OBJECTIVE:To evaluate the cost-effectiveness of biphasic insulin lispro mix 75/25 (LM75/25) and mix 50/50 (LM50/50) compared with a long-acting analog insulin (LAAI) regimen from the perspective of a US healthcare payer. METHODS:A published computer simulation model of diabetes was used to evaluate the cost-effectiven...
journal_title:Journal of medical economics
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更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To describe the changes in resource utilization in seven European countries (Germany, Greece, Portugal, Romania, Sweden, Spain, and Turkey) and direct costs in four European countries (Germany, Spain, Sweden, and Greece) over the first 12 months of insulin treatment in patients with type 2 diabetes mellitus ...
journal_title:Journal of medical economics
pub_type: 杂志文章,多中心研究
doi:10.3111/13696998.2013.812040
更新日期:2013-08-01 00:00:00
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journal_title:Journal of medical economics
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更新日期:2013-01-01 00:00:00
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journal_title:Journal of medical economics
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更新日期:2010-01-01 00:00:00
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1387118
更新日期:2018-01-01 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.673525
更新日期:2012-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
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更新日期:2013-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章,评审
doi:10.1080/13696998.2017.1396993
更新日期:2018-01-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
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更新日期:2013-09-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2012.667027
更新日期:2012-01-01 00:00:00
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journal_title:Journal of medical economics
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更新日期:2019-03-01 00:00:00
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journal_title:Journal of medical economics
pub_type: 杂志文章
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更新日期:2014-02-01 00:00:00
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journal_title:Journal of medical economics
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doi:10.3111/13696998.2015.1066796
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journal_title:Journal of medical economics
pub_type: 杂志文章,随机对照试验
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更新日期:2018-08-01 00:00:00
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journal_title:Journal of medical economics
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journal_title:Journal of medical economics
pub_type: 杂志文章
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journal_title:Journal of medical economics
pub_type: 杂志文章
doi:10.3111/13696998.2011.626822
更新日期:2011-01-01 00:00:00
abstract::Aims: OnabotulinumtoxinA is recommended by NICE for the treatment of chronic migraine. This economic evaluation provides updated estimates of the cost-effectiveness of onabotulinumtoxinA for chronic migraine using new utility estimates in an existing model structure.Methods: A previously published model was revised to...
journal_title:Journal of medical economics
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更新日期:2020-01-01 00:00:00
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更新日期:2018-11-21 00:00:00
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journal_title:Journal of medical economics
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abstract::Aims: To evaluate total costs and health consequences of a colorectal cancer (CRC) screening program with colonoscopy, fecal immunochemical tests (FIT), and expanded use of multitarget stool DNA (mt-sDNA) from the perspectives of Integrated Delivery Networks (IDNs) and payers in the United States.Materials and methods...
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更新日期:2020-06-01 00:00:00
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