New Long-Term Analysis of Clinical Treatment Outcomes Demonstrated Copaxone is More Cost Effective Than Tysabri for Treatment of Relapsing-Remitting Multiple Sclerosis
This is the first cost-effectiveness model comparing COPAXONE(R) and Tysabri(R) for treatment of multiple sclerosis (MS) to take into consideration long-term treatment outcomes, where available, effects on employment productivity and the effects of neutralizing antibodies (NAbs). Results from this analysis show incremental cost per quality-adjusted life years (QALY) for patients on COPAXONE(R) and Tysabri(R) compared to symptomatic treatment alone was $208,879, and $525,463, respectively.
"The results are consistent with the previously published analysis of this Markov model, which evaluated use of COPAXONE(R) and the beta interferons compared to symptom management alone for the treatment of relapsing-remitting MS. Both analyses demonstrated that in the presence of long-term treatment outcomes, COPAXONE(R) was the preferred treatment strategy in terms of outcomes and costs," said MerriKay Oleen-Burkey, Ph.D., Director, Health Outcomes Research at Teva Neuroscience, Inc. "COPAXONE(R) continues to show its value in reducing relapses and slowing detrimental change in EDSS, a measure of disability. Now we can confidently say in this model, it's less costly and more effective over a patient's lifetime than other treatments for RRMS."
Positive neutralizing antibodies (NAbs), is an immune system response to the injection of protein-based products such as Tysabri(R), which may inhibit its effectiveness and cause patients to have increased relapses. The model used in the present analysis assumed that NAbs would impact the probability of relapse only after the second year of continuous Tysabri(R) treatment and thereafter negatively affect treatment cost and outcomes to some degree.
"Cost-effectiveness and cost-utility analyses are useful tools for assessing the relationship between added costs and potential treatment benefits," stated Dr. Oleen-Burkey. "Although this study offers decision makers with relevant data to evaluate the cost-effectiveness of treatments for RRMS versus symptom management alone, it is important to point out that head-to-head randomized clinical trials comparing the immunomodulatory therapies are necessary to validate the projections from pharmacoeconomic models."
About the Study
A previously published literature-based Markov model has been updated to include Tysabri(R). The updated study estimates the economic outcomes of symptom management combined with COPAXONE(R) (glatiramer acetate injection) and Tysabri(R) compared to symptomatic treatment (e.g., physical therapy/exercise and pharmacological treatment) alone in patients diagnosed with RRMS. This new lifetime model considered long-term treatment outcomes where available, the potential impact of NAbs and the effects on employment/productivity. The model design took into account the acquisition costs of the MS therapies, state-specific MS-related medical costs, the cost of lost worker productivity and the additional costs for monitoring, diagnosis and treatment of progressive multifocal leukoencephalopathy (PML), a possible serious adverse event for patients on Tysabri(R).
The analysis indicated that COPAXONE(R) and Tysabri(R) were both more effective and more costly than symptomatic treatment alone. The total lifetime costs per patient for COPAXONE(R) were estimated to be 14 percent less than for Tysabri(R), their lifetime QALYs were comparable at 9.303 and 9.300, respectively. The incremental cost per QALY versus symptomatic treatment alone was $208,879 for COPAXONE(R) and $525,463 for Tysabri(R). Results demonstrated that COPAXONE(R) was less costly and more effective than Tysabri(R) in treating MS over a patient's lifetime.
The authors of this study note that limitations include reliance on clinical trial data, no inclusion of cost and utilities associated with adverse events except PML, assumptions surrounding the discontinuation and switching of therapies and estimation of clinical outcomes, lack of head-to-head clinical trials and clinical trial relapse rate criteria associated with this analysis.
MS is a chronic neurodegenerative inflammatory disease of the central nervous system with an overall prevalence rate of approximately 400,000 people. Previous research finds that costs associated with MS rise at an exponential rate with increasing MS disability levels.
Current data suggest COPAXONE(R) is a selective MHC class II modulator. COPAXONE(R) is indicated for the reduction of the frequency of relapses in RRMS. The most common side effects of COPAXONE(R) are redness, pain, swelling, itching, a lump or an indentation at the site of injection, weakness, infection, pain, nausea, joint pain, anxiety, and muscle stiffness.
COPAXONE(R) is now approved in 48 countries worldwide, including the United States, Canada, Mexico, Australia, Israel, and all European countries. In Europe, COPAXONE(R) is marketed by Teva Pharmaceutical Industries Ltd. and sanofi-aventis. In North America, COPAXONE(R) is marketed by Teva Neuroscience, Inc., which is a subsidiary of Teva Pharmaceutical Industries Ltd. (NASDAQ:TEVA). COPAXONE(R) is a registered trademark of Teva Pharmaceutical Industries Ltd.
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies in the world and is the leading generic pharmaceutical company. The company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients, as well as animal health pharmaceutical products. Close to 90 percent of Teva's sales are in North America and Europe. Teva's innovative R&D focuses on developing novel drugs for diseases of the central nervous system.
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Posted: October 2007