Summary
A new study co-funded by the National MS Society (USA), the National Institutes of Health and the University of Rochester examined the cost-effectiveness of therapies to treat MS, and found that the cost for improving the quality of life for people with MS in the U.S. is high. The study found that the earlier disease-modifying therapies were used, the more cost-effective they were, adding to growing evidence suggesting that treating MS early and consistently is the best way to ward off future disease activity. [Katia Noyes, PhD, MPH, and colleagues from the University of Rochester, New York. Neurology, published online July 20, 2011].
Details
Researchers from the University of Rochester, New York, analyzed data from 844 people with relapsing MS to estimate disease progression over a 10-year period. Data included health care costs, lost work time and other factors, and their use of disease-modifying MS therapies. The study determined how treatment affected quality-adjusted life years (QALY). QALY is a health-research measure which looks at quantity and quality of life, taking in to consideration therapeutic impacts as well as impacts such as disability-related unemployment. In this study, QALY allowed investigators to assess the efficacy of disease-modifying treatments in terms of impact on quality of life.
Cost-effectiveness studies analyze quality of life as it relates to health and examine what costs are involved in improving health-related quality of life.
Results indicated that disease-modifying therapies benefit people with MS although the extent of improvement in quality-adjusted life years provides modest benefits at a high cost on an overall basis. While they do not work for everyone, for many individuals, disease-modifying therapies have profoundly enhanced their ability to stay active and productive. In addition, starting disease-modifying therapy earlier was associated with greater health gains and better overall cost-effectiveness.
The study was not a clinical trial and did not measure whether the therapies altered disease progression leading to a higher level of disability. Further research is required to understand the long-term effects of MS therapies and their benefits on disease progression.
The management of MS has advanced considerably with the availability of disease-modifying agents. In the United States the first therapy was approved in 1993 and 1995 in Canada. Over the years, evidence from clinical trials and prescription use has shown their effectiveness in reducing the number and severity of MS relapses (reducing relapses by approximately one third to one half) and slowing disease progression. There are currently seven disease-modifying therapies approved in Canada ranging in cost from $20,000 - $40,000 per year (cost to individuals without private or public insurance coverage).
Although the majority of Canadians with MS who use disease modifying therapies have most of the cost reimbursed by private insurance plans and/or public drug programs, there are still gaps. The MS Society continues to urge federal, provincial and territorial governments to work together to develop an overall strategy that ensures Canadians have access to all Health Canada-approved drugs and to increase funding for costly drugs so Canadians need not spend more than three per cent of family income on prescription medications.
The preceding MS Update contains information from the National MS Society.