Background: Multiple sclerosis (MS) is a highly debilitating immune mediated disorder and the second most\r\ncommon cause of neurological disability in young and middle-aged adults. Iran is amongst high MS prevalence\r\ncountries (50/100,000). Economic burden of MS is a topic of important deliberation in economic evaluations study.\r\nTherefore determining of cost-effectiveness interferon beta (INF �Ÿ) and their copied biopharmaceuticals (CBPs) and\r\nbiosimilars products is significant issue for assessment of affordability in Lower-middle-income countries (LMICs).\r\nMethods: A literature-based Markov model was developed to assess the cost-effectiveness of three INF �Ÿs products\r\ncompared with placebo for managing a hypothetical cohort of patients diagnosed with relapsing remitting MS\r\n(RRMS) in Iran from a societal perspective. Health states were based on the Kurtzke Expanded Disability Status Scale\r\n(EDSS). Disease progression transition probabilities for symptom management and INF �Ÿ therapies were obtained\r\nfrom natural history studies and multicenter randomized controlled trials and their long term follow up for RRMS\r\nand secondary progressive MS (SPMS). A cross sectional study has been developed to evaluate cost and utility.\r\nTransitions among health states occurred in 2-years cycles for fifteen cycles and switching to other therapies was\r\nallowed. Calculations of costs and utilities were established by attachment of decision trees to the overall model.\r\nThe incremental cost effectiveness ratio (ICER) of cost/quality adjusted life year (QALY) for all available INF �Ÿ\r\nproducts (brands, biosimilars and CBPs) were considered. Both costs and utilities were discounted. Sensitivity\r\nanalyses were done to assess robustness of model.\r\nResults: ICER for Avonex, Rebif and Betaferon was 18712, 11832, 15768 US Dollars ($) respectively when utility\r\nattained from literature review has been considered. ICER for available CBPs and biosimilars in Iran was $847,\r\n$6964 and $11913.\r\n(Continued on next page)
Loading....