Cost-effectiveness of cladribine tablets and dimethyl fumarate in the treatment of relapsing remitting multiple sclerosis in Spain

J Comp Eff Res. 2023 Feb;12(2):e220193. doi: 10.2217/cer-2022-0193. Epub 2023 Jan 27.

Abstract

Aim: To analyze the cost-effectiveness of treatment of relapsing remitting multiple sclerosis (RRMS) with cladribine tablets (CladT) and dimethyl fumarate (DMF) from the perspective of the Spanish National Health System (NHS). Methods: A probabilistic Markov model (second-order Monte Carlo simulation) with a 10-year time horizon and annual Markov cycles was performed. Results: CladT was the dominant treatment, with lower costs (-74,741 € [95% CI: -67,247; -85,661 €]) and greater effectiveness (0.1920 [95% CI: -0.1659; 0.2173] QALY) per patient, compared with DMF. CladT had a 95.1% probability of being cost-effective and a 94.1% chance of being dominant compared with DMF. Conclusion: CladT is the dominant treatment (lower costs, with more QALYs) compared with DMF in the treatment of RRMS in Spain.

Keywords: cladribine tablets; cost–effectiveness; dimethyl fumarate; multiple sclerosis; relapsing-remitting multiple sclerosis.

MeSH terms

  • Cladribine / therapeutic use
  • Cost-Benefit Analysis
  • Dimethyl Fumarate / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Multiple Sclerosis*
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • Spain

Substances

  • Dimethyl Fumarate
  • Cladribine
  • Immunosuppressive Agents