Introduction of fingolimod for the treatment of multiple sclerosis in Colombia: a budget impact analysis
PDF (Español)
HTML (Español)

Keywords

Budget impact
Evaluation Studios
Fingolimod
Health Evaluation
Multiple Sclerosis Relapsing Remitting (MeSH)

Abstract

INTRODUCTION: multiple sclerosis (MS) is associated with long-term disability and significant social impact. First-line disease modifying treatments for MS (interferons and glatiramer acetate) have moderate efficacy and must be administered in daily or weekly injections. The introduction of fingolimod, a molecule with superior efficacy in reducing MS relapses compared to interferon-beta 1a justifies a budget impact analysis from a Colombian health system perspective.
OBJETIVES: to develop a budget impact analysis, for years 2012 to 2016, of the introduction of fingolimod in the Colombian health system.
MATERIALS AND METHODS: using the perspective of the Colombian health system, we designed a budget impact model to determine the effect that the introduction of fingolimod for patients with relapsing-remitting MS would have on the resources of the health system. Clinical data and prevalence were obtained from published literature, costs were collected from local sources. A Monte Carlo simulation was done as part of the sensitivity analysis. Exchange rate used was 2,565 pesos per euro (July 2011).
RESULTS: total annual net costs (2012-2016) for the scenario without fingolimod were, in million euros, €8.17, €8.69, €9.11, €9.62, and €10.13. In the fingolimod scenario net costs were: €8.19, €8.74, €9.16, €9.71 and €10.29. On the other hand, fingolimod was associated with 91 relapses averted in this five-year period. Monte Carlo simulation does not show relevant differences in costs between both scenarios.
CONCLUSION: under these assumptions, the introduction of fingolimod in Colombian health care system does not imply a significant budget impact but represents an important reduction in the number MS relapses.


PDF (Español)
HTML (Español)

References

DE SÁ J. Epidemiología de la esclerosis múltiple en Portugal y España. Rev Neurol2010; 51: 387-392.

AMATO MP. Pharmacoeconomic considerations of multiple sclerosis therapy with the new disease modifying agents. Expert Opin Pharmacother 2004; 5: 2115-2126.

SÁNCHEZ JL, AGUIRRE C, ARCOS-BURGOS OM, JIMÉNEZ I. JIMÉNEZ M, LEÓN F, ET AL. Prevalencia de la esclerosis múltiple en Colombia. Rev Neurol 2000; 31: 1101-1103.

BENITO-LEÓN J, BERMEJO-PAREJA F. ¿Está cambiando la epidemiología de la esclerosis múltiple? Rev Neurol 2010; 51: 385-386.

PUTZKI N, FISCHER J, GOTTWALD K, REIFSCHNEIDER G, RIES S, SIEDER A, HOFFMANN F, ET AL. Quality of life in 1000 patients with early relapsing-remitting multiple sclerosis. Eur J Neurol 2009; 16: 713-720.

RICE GP, INCORVAIA B, MUNARI L, EBERS G, POLMAN C, D'AMICO R, ET AL. Interferon in relapsing-remitting multiple sclerosis. Cochrane Database Syst Rev 2001; (4): CD00202.

Datamonitor. Stakeholder Insight: Multiple sclerosis. disease-modifying efficacy and side effects guide treatment choice. 2006. URL: http://www.datamonitor.com (10.11.2008).

MATLOUBIAN M, LO CG, CINAMON G. Lymphocyte egress from thymus and peripheral lynphoid organs is dependent on S1P receptor 1. Nature 2004; 427: 355-360.

COELHO RP, PAYNE SG, BITTMAN R. The immunomodulator FTY720 has a direct cytoprotec-tive effect in oligodendrocyte progenitors. J Pharmacol Exp Ther 2007; 323: 626-635.

BARSKE C, OSINDE M, KLEIN C. FTY720 and SIP-receptor 1 and 5 specific agonist increase the number of oligodendrocytes in vitro. Neurology 2008; 70: Suppl 1: A28.

MIRON VE, JUNG CG, KIM HL. FTY720 modulates human oligodendrocyte progenitor process extension and survival. Ann Neurol 2008; 63: 61-71.

KAPPOS L, RADUE EW, O'CONNOR P, POLMAN C, HOHLFELD R, CALABRESI P, ET AL. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med 2010; 362: 387-401.

COHEN JA, BARKHOF F, COMI G, HARTUNG HP, KHATRI BO, MONTALBAN X, ET AL. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med 2010; 362: 402-415.

CUBILLOS L, ALFONSO E. Análisis descriptivo preliminar de los recobros en el Sistema General de Seguridad Social en Salud. Ministerio de la Protección Social 2005. http://www.med-informatica.com (31.01.2011).

MAUSKOPF JA, SULLIVAN SD, ANNEMANS L, CARO J, MULLINS CD, NUIJTEN M, ET AL. Principles of good practice for budget impact analysis. Value Health 2007; 10: 336-347.

SÁNCHEZ-DE LA ROSA R, SAVATER E, CASADO MA. Análisis del impacto presupuestal del tratamiento en primera línea de la esclerosis múltiple remitente recurrente en España. Rev Neurol 2011; 53:129-138.

CONFAVREUX C, VUKUSIC S, MOREAU T, ADELEINE P. Relapses and progression of disability in multiple sclerosis. N Engl J Med 2000; 343: 14301438.

CREE B, STUART W, TORNATORE C, JEF-FERY DR, PACE AL, CHA CH. Efficacy of Natali-zumab Therapy in patients of African descent with relapsing multiple sclerosis: analysis of AFFIRM and SENTINEL data. Arch Neurol2011; 68: 464-468.

BONESCHI F, ROVARIS M, JOHNSON K, MILLER A, WOLINSKY JS, LADKANI D, ET AL. Effects of glatiramer acetate on relapse rate and accumulated disability in multiple sclerosis: meta-analysis of three double-blind, randomized, placebo-controlled clinical trials. Multiple Sclerosis 2003; 9: 349-355.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Downloads

Download data is not yet available.