Cost-utility analysis of teriflunomide in naive vs. previously treated patients with relapsing-remitting multiple sclerosis in Italy

Background Multiple sclerosis (MS) accounts for 176 cases per 100,000 inhabitants (female/male ratio =2:1) in Italy. For most of the patients (67%), the disease course is relapsing-remitting MS (RRMS). Objective To compare the costs and quality-adjusted life years (QALYs) of teriflunomide in RRMS naive patients vs. RRMS patients previously treated (experienced) with other disease-modifying therapies in Italy. Methods A four health states Markov model-supported cost-utility analysis (CUA) covering a 7-year timespan through annual cycles was developed, following the healthcare sector and the societal viewpoints. Part of the parameters that populated the Markov model was obtained from a questionnaire administered to four primary Italian MS centres. Costs of healthcare and non-healthcare resources, expressed in euro (sic) 2019, and QALYs were discounted at 3% real social discount rate. One-way, scenario and probabilistic sensitivity analyses tested the uncertainty of the baseline findings. Results Baseline CUA shows that teriflunomide in RRMS naive patients is strongly dominant vs. experienced patients (healthcare sector perspective: - (sic)1042.68 and + 0.480 QALYs; societal perspective: - (sic)6782.81 and + 0.480 QALYs). Sensitivity analyses confirmed the robustness of the baseline results. Conclusion Teriflunomide in RRMS naive vs. experienced patients is cost-effective and possibly strongly dominant from both the healthcare sector and the society viewpoints in Italy. Our findings need further confirmation from real-world studies.

Automated summary

This study aimed to compare the costs and quality-adjusted life years (QALYs) of teriflunomide in naïve patients with relapsing-remitting multiple sclerosis (RRMS) and experienced patients previously treated with other disease-modifying therapies in Italy. The results showed that teriflunomide was cost-effective and potentially strongly dominant in naïve RRMS patients from both the healthcare sector and societal viewpoints.