The cost of treating multiple sclerosis (MS) with a certain class of drugs is significantly higher than the cost of addressing the symptoms of MS with other therapies, according to a study in the journal Neurology.
Analyzing data from 844 individuals with early-stage MS and projecting health-care costs, including the cost of the drugs and lost productivity over a 10-year period, the study found that MS patients using disease-modifying drugs experienced modest health gains. But the cost associated with using such drugs is more than eight times higher than what is considered “reasonable” from a cost-effectiveness perspective.
“While it is clear that disease-modifying drugs are beneficial to some MS patients, those gains come at a tremendous economic cost,” said Katia Noyes, Ph.D., M.P.H., associate professor in the Department of Community and Preventive Medicine at the University of Rochester Medical Center and lead author of the study. “These results point to the need to continually evaluate the cost-effectiveness of new treatments in the interest of controlling health care costs.”
MS, a disease of the central nervous system, is the most common cause of neurological disability in young adults, causing muscle weakness, numbness or tingling in arms and legs, difficulty with coordination, balance and walking, blurred vision and slurred speech. The disease first manifests in cycles of acute symptoms followed by periods of remission and recovery. Eventually, the symptoms generally become debilitating.
Several new drugs introduced in the 1990s modified the course of the disease; traditional therapies primarily treat the symptoms of the disease. The drugs have been shown in large clinical studies to slow the progression of the disease and reduce relapses, but are associated with side effects and are very expensive — as much as $30,000 per year.
The researchers employed a method called quality-adjusted life years (QALY) to evaluate the health effects of the drugs. QALY is a standard tool for evaluating disease burden by estimating the improved quality of life gained over time from a particular medication or course of therapy. Health policy experts generally accept that for an intervention to be judged “cost-effective” it should cost $100,000 or less to produce an extra QALY. According to the study, disease-modifying drugs for MS cost more than $800,000 per QALY.
And that came with only a modest improvement in health, according to the study. For example, MS patients taking one of the drugs gained about two quality-adjusted months over 10 years compared with patients who did not take disease-modifying drugs. They had an average of six out of 10 free of relapses compared with five years for patients not taking the drugs. The authors also found that the benefit to patients was greater if they began taking the drugs early during the onset of the disease.