The budgetary impact of alemtuzumab in multiple sclerosis in Quito, Ecuador. Payer’s perspective
DOI:
https://doi.org/10.33393/grhta.2021.2273Keywords:
Multiple sclerosis, Interferons, Budgetary impact analysis, Fingolimod, Alemtuzumab, TeriflunomideAbstract
Introduction: Multiple sclerosis is a neurological condition that causes disabilities and is most common in young adults. It imposes high financial costs affecting the quality of life of patients, families, and society. It is critical to measure the budgetary impact of new technologies to treat this disease.
Objective: The aim of the article is to estimate the budgetary impact of introducing alemtuzumab as an escalation therapy in patients diagnosed with Recurrent Remitting Multiple Sclerosis and treated in Quito, Ecuador.
Materials and methods: A cohort of 85 patients receiving treatment with disease-modifying therapies was used, within a 5-year timeframe, between 2021 and 2025. The baseline scenario, including the percentages of administration of the different drugs, is compared with the alternative scenario, including alemtuzumab. The cost assessment included only direct medical resources. To obtain local resources for management of the disease, a neurologist and clinical expert who treats most of the patients in Quito was consulted.
Results: Considering a cohort of 85 patients with active Recurrent Remitting Multiple Sclerosis, the average global budget impact in 5 years would be USD 10,603,230.00 in the base case and USD 9,995,817.00 in the alemtuzumab scenario.
Conclusion: The inclusion of alemtuzumab as escalation therapy represents budgetary savings over the next 5 years (2021-2025).
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Fernández O, Fernández VE, Guerrero M. Esclerosis múltiple. Medicine (Spain). Published online 2015;77:4610-4621. https://doi.org/10.1016/j.med.2015.04.002 DOI: https://doi.org/10.1016/j.med.2015.04.002
FAGUY K. Multiple Sclerosis: An Update. Radiol... - Google Académico. Accessed July 16, 2020. https://scholar.google.es/scholar?hl=es&as_sdt=0%2C5&q=3.%09FAGUY+K.+Multiple+Sclerosis%3A+An+Update.+Radiol+Technol.+2016+May%3B87%285%29%3A529-50.+PMID%3A+27146176.&btnG=
Maia C, Costa A, Abreu P, Sá MJ. All-cause hospitalizations in multiple sclerosis patients. Rev Neurol. 2019;68(6):229-235. https://doi.org/10.33588/rn.6806.2018281 PMID:30855706 DOI: https://doi.org/10.33588/rn.6806.2018281
Bravo-González F, Álvarez-Roldán A. [Multiple sclerosis, loss of functionality and gender]. Gac Sanit. 2019;33(2):177-184. https://doi.org/10.1016/j.gaceta.2017.09.010 PMID:29203325 DOI: https://doi.org/10.1016/j.gaceta.2017.09.010
Moreno RD, Morales Esponda M, Lorena N, et al. Esclerosis Múltiple: Revisión de La Literatura Médica.
Delgado FR, Margarit BP, Monteiro GC, Izquierdo AY. Diagnostic and therapeutic protocol for multiple sclerosis flare-ups. Medicine (Spain). 2019;12(78):4630-4633. https://doi.org/10.1016/j.med.2019.05.014 DOI: https://doi.org/10.1016/j.med.2019.05.014
Consolidado precios techo actualizado 2018-10-02 – Ministerio de Salud Pública. Accessed July 16, 2020. https://www.salud.gob.ec/consejo-nacional-de-fijacion-y-revision-de-precios-de-medicamentos/consolidado-precios-techo-actualizado-2018-10-02/
MSP. Gobierno de la República del Ecuador. Ministerio de Salud Pública. Tarifario de Prestaciones para el Sistema Nacional de Salud 2014. Accessed July 16, 2020. https://aplicaciones.msp.gob.ec/salud/archivosdigitales/documentosDirecciones/dnn/archivos/TARIFARIO.pdf
Huamaní C, Rojas E, Inca J. Esclerosis múltiple de alta actividad: ¿se puede iniciar precozmente el tratamiento con drogas de alta eficacia? Acta Med Peru. 2017;34(4):301-8. http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172017000400008, accessed July 16, 2020. DOI: https://doi.org/10.35663/amp.2017.344.463
Vizcarra DR, Cruz AG, Rojas E, et al. Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Esclerosis Múltiple en Adultos. Rev Neuropsiquiatr. 2019;82(4):242-257. https://doi.org/10.20453/rnp.v82i4.3646 DOI: https://doi.org/10.20453/rnp.v82i4.3646
Sullivan SD, Mauskopf JA, Augustovski F, et al. Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014;17(1):5-14. https://doi.org/10.1016/j.jval.2013.08.2291 PMID:24438712 DOI: https://doi.org/10.1016/j.jval.2013.08.2291
Pastor Quirós L, Ugalde R. Análisis del impacto presupuestario de alemtuzumab como terapia de segunda línea, en comparación con natalizumab y fingolimod, en pacientes previamente tratados con interferón beta 1b, diagnosticados con esclerosis múltiple remitente recurrente activa, Glob Reg Health Technol Assess; 2019:6(1) https://doi.org/10.1177/2284240319833287 DOI: https://doi.org/10.1177/2284240319833287
Coles AJ, Twyman CL, Arnolod DL et al. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial. The Lancet 2012;380:1829-1839. https://doi.org/10.1016/S0140-6736(12)61768-1 PMID DOI: https://doi.org/10.1016/S0140-6736(12)61768-1
EMA. Ocrevus. Annex I Summary of Product Characteristics. Accessed July 16, 2020. https://www.ema.europa.eu/en/documents/product-information/ocrevus-epar-product-information_es.pdf
EMA. Avonex. Annex I Summary of Product Characteristics. Accessed July 16, 2020. https://www.ema.europa.eu/en/documents/product-information/avonex-epar-product-information_en.pdf
EMA. Gilenya. Annex I Summary of Product Characteristics. Accessed July 16, 2020. https://www.ema.europa.eu/en/documents/product-information/gilenya-epar-product-information_en.pdf
EMA. Aubagio. Annex I Summary of Product Characteristics. Accessed July 16, 2020. https://www.ema.europa.eu/en/documents/product-information/aubagio-epar-product-information_en.pdf
EMA. Rebif. Annex I Summary of Product Characteristics. Accessed July 16, 2020. https://www.ema.europa.eu/en/documents/product-information/rebif-epar-product-information_en.pdf
Tramacere I, Del Giovane C, Salanti G, D’Amico R, Filippini G. Immunomodulators and immunosuppressants for relapsing-remitting multiple sclerosis: a network meta-analysis. Cochrane Database Syst Rev. 2015(9):CD011381. https://doi.org/10.1002/14651858.CD011381.pub2 PMID:26384035 DOI: https://doi.org/10.1002/14651858.CD011381
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2021-09-17
Published 2021-10-21
