Measuring the cost-effectiveness of treatments for people with multiple sclerosis: Beyond quality-adjusted life-years

Background: It is a familiar story. A promising multiple sclerosis (MS) treatment clears the three regulatory hurdles of safety, quality and efficacy, only to fall at the fourth: cost-effectiveness. This has led to concerns about the validity of the measures typically used to quantify treatment effects in cost-effectiveness analyses and in 2012, in the United Kingdom, the National Institute for Health and Care Excellence called for an improvement in the cost-effectiveness framework for assessing MS treatments. Objective and Methods: This review describes what is meant by cost-effectiveness in health/social care funding decision-making, and usual practice for assessing treatment benefits. Results: We detail the use of the quality-adjusted life-year (QALY) in resource allocation decisions, and set out limitations of this approach in the context of MS. Conclusion: We conclude by highlighting methodological and policy developments which should aid addressing these limitations.

Automated summary

This review discusses the cost-effectiveness of multiple sclerosis treatment, explores the use of quality-adjusted life-years (QALYs) in resource allocation decisions, and highlights the limitations of this approach in the context of multiple sclerosis. The article concludes by suggesting methodological and policy developments that could address these limitations.