RT Journal Article
T1 Comparative Effectiveness and Cost-Effectiveness of Natalizumab and Fingolimod in Patients with Inadequate Response to Disease-Modifying Therapies in Relapsing-Remitting Multiple Sclerosis in the United Kingdom.
A1 Spelman, Timothy
A1 Herring, William L
A1 Zhang, Yuanhui
A1 Tempest, Michael
A1 Pearson, Isobel
A1 Freudensprung, Ulrich
A1 Acosta, Carlos
A1 Dort, Thibaut
A1 Hyde, Robert
A1 Havrdova, Eva
A1 Horakova, Dana
A1 Trojano, Maria
A1 De Luca, Giovanna
A1 Lugaresi, Alessandra
A1 Izquierdo, Guillermo
A1 Grammond, Pierre
A1 Duquette, Pierre
A1 Alroughani, Raed
A1 Pucci, Eugenio
A1 Granella, Franco
A1 Lechner-Scott, Jeannette
A1 Sola, Patrizia
A1 Ferraro, Diana
A1 Grand'Maison, Francois
A1 Terzi, Murat
A1 Rozsa, Csilla
A1 Boz, Cavit
A1 Hupperts, Raymond
A1 Van Pesch, Vincent
A1 Oreja-Guevara, Celia
A1 van der Walt, Anneke
A1 Jokubaitis, Vilija G
A1 Kalincik, Tomas
A1 Butzkueven, Helmut
A1 MSBase Investigators, 
AB Patients with highly active relapsing-remitting multiple sclerosis inadequately responding to first-line therapies (interferon-based therapies, glatiramer acetate, dimethyl fumarate, and teriflunomide, known collectively as "BRACETD") often switch to natalizumab or fingolimod. The aim was to estimate the comparative effectiveness of switching to natalizumab or fingolimod or within BRACETD using real-world data and to evaluate the cost-effectiveness of switching to natalizumab versus fingolimod using a United Kingdom (UK) third-party payer perspective. Real-world data were obtained from MSBase for patients relapsing on BRACETD in the year before switching to natalizumab or fingolimod or within BRACETD. Three-way-multinomial-propensity-score-matched cohorts were identified, and comparisons between treatment groups were conducted for annualised relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M). Results were applied in a cost-effectiveness model over a lifetime horizon using a published Markov structure with health states based on the Expanded Disability Status Scale. Other model parameters were obtained from the UK MS Survey 2015, published literature, and publicly available UK sources. The MSBase analysis found a significant reduction in ARR (rate ratio [RR] = 0.64; 95% confidence interval [CI] 0.57-0.72; p  This novel real-world analysis suggests a clinical benefit for therapy escalation to natalizumab versus fingolimod based on comparative effectiveness results, translating to higher QALYs and lower costs for UK patients inadequately responding to BRACETD.
YR 2021
FD 2021-12-18
LK http://hdl.handle.net/10668/21696
UL http://hdl.handle.net/10668/21696
LA en
DS RISalud
RD Apr 12, 2025