Averting multiple sclerosis long-term societal and healthcare costs: The Value of Treatment (VoT) project

Background and purpose: The recent report on Value-of-Treatment (VoT) project highlights the need for early diagnosis-intervention, integrated, seamless care underpinning timely care pathways and access to best treatments. The VoT-multiple-sclerosis (MS) economic case study analysis aimed to estimate the effectiveness/costeffectiveness of both early treatment and reducing MS risk factors (e.g. smoking and vitamin D insufficiency). Methods: A series of decision analytical modellings were developed and applied to estimate the cost-effectiveness of: (1) reducing the conversion from clinically-isolated-syndrome (CIS) to clinically-definite-MS (CDMS); (2) smoking cessation and increase of 25 hydroxyvitamin D (25(OH)D) serum level. Both (1) and (2) considered socioeconomic impact on averted MS disability progression. Costs were reported for societal and healthcare provider perspectives (pending on data across nations; Euros). Effectiveness was expressed as Quality-AdjustedLife-Years (QALYs) gains. Long term (25, 30, 40,50-years) and short (one-year) timelines were considered for (1) and (2), respectively. Results: Early treatment was cost-effective for the health care provider and both cost-effective/cost-saving for the society across time-horizons and nations. Smoking cessation and an increase of 25(OH)D in MS patients were both cost-effective/cost-saving across nations. Conclusions: To the best of our knowledge, our work provides the first economic evidence to base appropriate public health interventions to reduce the MS burden in Europe.

Automated summary

The recent report on the Value-of-Treatment (VoT) project emphasizes the importance of early diagnosis-intervention and integrated care. The economic case study analysis of VoT in multiple sclerosis (MS) showed that early treatment is cost-effective for healthcare providers and society, while smoking cessation and increasing 25(OH)D levels in MS patients are also cost-effective across nations. Overall, the research provides important economic evidence for public health interventions to reduce the MS burden in Europe.