Abstract Details

Title Cost effectiveness of Ofatumumab in Comparison with Other Disease Modifying Therapies and Best Supportive Care for the Treatment of Relapsing-Remitting Multiple Sclerosis in Canada

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 350

Objective

To evaluate the cost effectiveness of ofatumumab against other disease-modifying therapies (DMTs) and best supportive care (BSC) for the treatment of adult patients with relapsing-remitting Multiple Sclerosis (RRMS) from a Canadian healthcare system perspective.

Background Ofatumumab is a high-efficacy, first-line DMT with a favorable benefit-risk profile recently approved in Canada to treat RRMS with active disease.

Design/Methods A Markov cohort model with 10 total health states representing disability status defined by the Expanded Disability Status Scale (EDSS) levels 0 to 9 and a death state (EDSS 10) was run over 65-years using an annual cycle length, 1.5% annual discount rate, and 100% treatment discontinuation at 10 years. Probabilistic analyses were conducted sequentially as per Canadian guidelines. Baseline patient distribution was informed by the ASCLEPIOS trials. Each year, patients could transition between EDSS states, experience a relapse, discontinue therapy, or die. Natural history transition probabilities were informed by the British Columbia database. Treatment effects for each DMT were modelled using hazard ratios for 6-month confirmed disability progression and annualized relapse rates from a published network meta-analysis. Treatment-related adverse event probabilities were based on individual clinical trials. Health utilities and costs were obtained from Canadian sources (where possible) and the literature.

Results Ofatumumab was dominant (more efficacy, lower costs) over first-line DMTs teriflunomide, interferons, dimethyl fumarate, and ocrelizumab, and resulted in incremental cost-effectiveness ratios (ICERs) of $24,177 Canadian dollars per quality-adjusted life-years (QALYs) gained versus glatiramer acetate and $28,034 versus BSC. At a willingness-to-pay threshold of $50,000/QALY, ofatumumab had the highest probability of being cost effective (63.3%). Scenario analysis results demonstrated that ofatumumab dominated second-line treatments natalizumab and fingolimod; and resulted in an ICER of $50,899 versus cladribine.

Conclusions

Ofatumumab is cost effective against all comparators and dominant against all currently approved and reimbursed first-line DMTs for RRMS, except glatiramer acetate.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Nicholas Adlard	Nicholas Adlard has received personal compensation for serving as an employee of Novartis Pharma AG.
	No disclosure on file
Francois Blanchette	Francois Blanchette has nothing to disclose.
	No disclosure on file
Moogeh Baharnoori (Kingston General Hospital)	Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme . Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD serono. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis . Dr. Baharnoori has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Virender Bhan, MD	Dr. Bhan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bhan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bhan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Bhan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Bhan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi.
Fraser M. Clift, MD (Eastern Health)	Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen . Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono . Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi . Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Clift has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Clift has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.
	No disclosure on file

��ɫ��

��ɫ��