Hurtigoversikt
Natalizumab for treatment of MS – Health economics
Mapping review
|Updated
Key message
The systematic review of health economic analysis of natalizumab in patients with MS gave a total of three reports where two different models relevant for Norway were presented. All analyses indicate that natalizumab versus current treatment with DMDs gave incremental QALY gains in favour of natalizumab.
The analyses varied considerably from NOK 993 036 per QALY (when only direct health care costs were included) to cost-saving due to less need for health care services and productivity gains (when indirect costs were included).
Our evaluations of these analyses find it difficult to conclude if and to which extent natalizumab is cost-effective compared with current treatment in the relevant patient population. There are three main reasons for this:
1. None of the analysis show the result of natalizumab versus current treatment with DMDs in the relevant subpopulation of MS-patients where natalizumab has an approved indication for use in Norway.
2. General uncertainty present in the analysis. Efficacy data from the clinical trial is extrapolated from a 2 years until 20 years time horizon. The health economic analysis comparing natalizumab versus current treatment are based on uncertain, indirect comparison of efficacy data from several different sources. Uncertainty with respect to the modelling of drug withdrawals and a large variation in the cost estimates are also present.
3. The reports contain little information on the total degree of uncertainty in the data and the analysis. An attempt to quantify the uncertainty through a probabilistic sensitivity analysis is only presented in one of the reports.
About the report:
Cost-effectiveness analyses give the decision-makers information on the cost of a treatment related to its effect. These analyses will also provide information on the uncertainty of these calculations and aid in identification of areas for where future analyses and research are needed.