Cost-Effectiveness of Natalizumab Compared With Fingolimod for Relapsing-Remitting Multiple Sclerosis Treatment in Colombia

Lasalvia, Pieralessandro; Hernández, Fabián; Castañeda-Cardona, Camilo; Cuestas, Andrés; Rosselli, Diego

dc.rights.licence	Atribución-NoComercial 4.0 Internacional	*
dc.contributor.author	Lasalvia, Pieralessandro
dc.contributor.author	Hernández, Fabián
dc.contributor.author	Castañeda-Cardona, Camilo
dc.contributor.author	Cuestas, Andrés
dc.contributor.author	Rosselli, Diego
dc.coverage.spatial	Colombia	spa
dc.date.accessioned	2020-09-17T00:23:53Z
dc.date.available	2020-09-17T00:23:53Z
dc.date.created	2020-01-28
dc.identifier	https://www-sciencedirect-com.ezproxy.javeriana.edu.co/science/article/pii/S2212109919306272?via%3Dihub	spa
dc.identifier.issn	2212-11028 / 2212-1099 (Electrónico)	spa
dc.identifier.uri	http://hdl.handle.net/10554/51082
dc.format	PDF	spa
dc.format.mimetype	application/pdf	spa
dc.language	Inglés	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc/4.0/	*
dc.source	Value in Health Regional Issues; Vol. 23 (2020)	spa
dc.title	Cost-Effectiveness of Natalizumab Compared With Fingolimod for Relapsing-Remitting Multiple Sclerosis Treatment in Colombia	spa
dc.type	info:eu-repo/semantics/article
dc.type.hasversion	http://purl.org/coar/version/c_ab4af688f83e57aa
dc.description.quartilescopus	Q1	spa
dc.identifier.doi	https://doi.org/10.1016/j.vhri.2019.08.481	spa
dc.description.tipoarticulo	Artículo completo	spa
dc.description.paginas	13-18	spa
dc.format.soporte	Electrónico	spa
dc.subject.keyword	Cost-effectiveness	spa
dc.subject.keyword	Fingolimod	spa
dc.subject.keyword	Multiple sclerosis	spa
dc.subject.keyword	Natalizumab	spa
dc.subject.keyword	Relapsing-remitting	spa
dc.description.abstractenglish	Objectives: Multiple sclerosis (MS) is a degenerative neurological disorder. Treatment aims to avoid relapses and disability progression. The purpose of this study was to evaluate the cost-effectiveness of natalizumab compared with fingolimod for treating highly active relapsing-remitting MS (RRMS) patients from the Colombian third-party payer perspective. Methods: We used a Markov economic model from the perspective of the Colombian healthcare system to estimate the costeffectiveness of natalizumab compared with fingolimod for RRMS with high disease activity or failure of interferons as firstline therapy. This model was centered on disability progression and relapses. We considered a 5-year time horizon with a 5% discount rate. We included only direct medical costs. Local experts were consulted to obtain resource utilization estimates, and local standardized costing methodologies and sources were used. Outcome was considered in terms of quality-adjusted life-years (QALYs). Utilities were extracted or calculated from the literature. Transition probabilities were calculated from available efficacy and safety information (1 USD = 3050.98 COP). Results: Natalizumab showed lower total costs (USD 80 024 vs USD 98 137) and higher QALY yield (3.01 vs 2.94) than fingolimod, dominating it (incremental cost-effectiveness ratio = 2$1861). Univariate sensitivity analysis showcased the relevance of the measures of effect on disability progression for natalizumab on model results. Probabilistic sensitivity analysis replicated base-case results in most simulations. Conclusions: This study showed that natalizumab dominated fingolimod with lower costs and higher QALYs in patients with high-activity RRMS. These results are consistent with previous published international literature.	spa
dc.type.local	Artículo de revista	spa
dc.contributor.corporatename	Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística