Abstract Details

Title Cost effectiveness of Fingolimod Compared to Interferon-ß1a in the Management of Pediatric-Onset Multiple Sclerosis (POMS) in Canada

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-106

Objective To evaluate the cost effectiveness of fingolimod compared to interferon-β1a for the treatment of POMS.

Background Fingolimod has been shown to be more effective than interferon-β1a for treatment of POMS (children aged 10- <18 years) in the PARADIGMS study, however, it comes at a higher drug acquisition cost.

Design/Methods A discrete time Markov model comparing fingolimod to interferon-β1a over a lifetime horizon from a Canadian Healthcare system perspective was developed. Twenty-one health states based on the Expanded Disability Status Scale (EDSS) were taken into account: EDSS 0-9 for relapsing MS, EDSS 0-9 for secondary progressive MS, and “Death”. Estimates of relative treatment efficacy for POMS and adult-onset MS (AOMS) were assumed to be similar to the efficacy of fingolimod in POMS as observed in the PARADIGMS study and in AOMS as observed in the TRANSFORMS study, as well as a published mixed treatment comparison. Costs and resource use were obtained from published literature and Canadian sources. Utilities were estimated by mapping Pediatric Quality of Life (PedsQL) inventory data on to the Child Health Utility Index 9D (CHU9D) using a published mapping algorithm. Future costs and benefits were discounted at 1.5% per annum. Key outcomes included quality-adjusted life years (QALYs) gained and the incremental cost-effectiveness ratio. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the results.

Results Fingolimod compared to interferon- β1a reported a quality adjusted life year (QALY) gain of 1.731 with an additional cost of CAD$ 17,200, corresponding to an Incremental Cost- Effectiveness Ratio (ICER) of CAD$ 9,935/QALY over lifetime horizon. Base-case results show that benefits accrued on fingolimod treatment were higher than the costs incurred at a commonly acceptable willingness-to-pay (WTP) threshold of CAD$ 50,000/QALY.

Conclusions Fingolimod is more cost effective compared to interferon-β1a for the treatment of pediatric-onset (POMS) over a lifetime horizon in Canada.

Authors/Disclosures
Hamid Reza Nakhaipour PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Robyn Schecter (Novartis)	No disclosure on file
Daniela Pohl	Daniela Pohl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos.
Nicholas Adlard	Nicholas Adlard has received personal compensation for serving as an employee of Novartis Pharma AG.

��ɫ��

��ɫ��