[Pharmacoeconomic analysis of the efficacy of natalizumab in relapsing-remitting multiple sclerosis].

OBJECTIVE: To perform pharmacoeconomic assessment of interferone-1a for intramuscular and subcortical infusions, interferon-beta-1b, glatiramer acetate and natalizumab in the treatment of relapsing-remitting multiple sclerosis (RRMS). MATERIAL AND METHODS: Modeling and "cost-effectiveness" analysis as well as evaluation of "disease cost" were performed. A model was based on the data on the efficacy of the drugs, summarized in the meta-analysis of G.Filippini et al, and treatment costs in the Russian health care system. To compare the efficacy, we used a criteria of "reduction of the risk of 1 and more relapses during 2 years of treatment compared to placebo". The analysis of treatment costs of patients with RRMS included direct treatment costs during the remission, medical care costs and costs of disease-modifying drugs (DMD). The analysis of direct costs was performed using standards of treatment of patients with multiple sclerosis. The duration of the study was 2 years. RESULTS AND CONCLUSION: Based on the meta analysis, we calculated the relative decrease of the risk of 1 and more relapses during 2 years of treatment as 3,6 % for interferon-beta-1b for intramuscular infusions (avonex), 15,2% for interferon-beta-1b for subcortical infusions (rebif), 10,5% for interferon-beta-1b for (betaferon), 21,6% for glatiramer acetate (copaxone), 42,8% for natalizumab (tisabri). For 2 years, total management costs per patient were 1567082,98 rub for avonex, 1563369,38 rub for rebif, 1322 635,80 for betaferon, 1 459 976,15 rub. for copaxone and 2 694 699,35 rub. for tisabri. The minimal cost/effectiveness ratio (62 960,27 rub.) was calculated for natalizumab. This drug was most preferable in terms of economic effectiveness.