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Study Questions Cost-Effectiveness of MS Drugs

Doctors Express Concern About Soaring Prices of Disease-Modifying Drugs for Multiple Sclerosis

Why Cost-Effectiveness Matters continued...

Cost-effectiveness is a metric used by economists to try to gauge the size of the benefit patients appear to get for their health care dollar.

It's become a buzzword as the government and health insurers try to figure out which treatments are worth covering and how to control skyrocketing health care costs.

In the U.S., there is no set threshold that determines cost-effectiveness, but other countries and some health care agencies use a figure around $50,000 per quality-adjusted life year as one cutoff.

The study found disease-modifying drugs for multiple sclerosis are about 16 times more expensive than that.

"When we talk about effectiveness, we're talking about average effectiveness. If we look at the individual person, many of them will have great benefits, and there will be some who have no benefit at all or even negative effects," Noyes says. "So here is a trade-off between national policy or population-based policy and individual patients."

For the study, researchers extracted data on 844 people with MS who were part of a large national patient database. They collected information on things like health care costs, lost work time, disease severity, disease progression, and medications, and they used that information to develop mathematical models.

Over 10 years, the models estimated that the average cost to treat one patient was $267,710 with supportive care, but nearly doubled when researchers added the costs of disease-modifying drugs to the equation.

Overall, health outcomes for patients on the disease-modifying drugs appeared to be only slightly better than for those on supportive care.

Making Improvements in Cost-Effectiveness

Other countries pay far less for the same medications.

Patients in the U.K., for example, get the drug Betaseron for about $12,000 a year, while it costs about $34,000 in the U.S.

Researchers say that if the U.S. were to see prices for these drugs like those paid by patients in the U.K., the treatments could achieve more accepted levels of cost-effectiveness.

The cost-effectiveness also improved when people were started on the drugs early in the course of their disease, when the medications could still prevent permanent nerve damage, perhaps keeping them healthier, longer.

The impact of the study will be "a good deal of discussion concerning where we are in the treatment of MS in terms of cost, obviously, and in terms of where we would like to go in the future," says Nicholas LaRocca, PhD, vice president of health care delivery and policy research at the National Multiple Sclerosis Society. The organization helped to fund the study.

"I would imagine that some people will look at this study and will feel that it will discourage the availability of treatment, but I don't really see that happening," he says. "We need to do more studies like this."

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