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The following is a summary of “Cost–consequence analysis of early vs. delayed natalizumab use in highly active relapsing–remitting multiple sclerosis: a simulation study,” published in the January 2025 issue of Neurology by Inojosa et al.
Natalizumab (NAT) is a key disease-modifying therapy for highly active multiple sclerosis (MS). The approval of the first biosimilar NAT has introduced competitive pricing, influencing treatment decisions.
Researchers conducted a retrospective study to assess the societal implications of initiating NAT in different scenarios.
They used a 10-year Markov model with 11 health states and annual cycles based on the EDSS to compare NAT with common therapies (glatiramer acetate, teriflunomide, dimethyl fumarate, and fingolimod). The cohort, aged 36 years with 70% females, was analyzed under continuous, early (1 year), and delayed (5 years) NAT switch scenarios, with outcomes derived from clinical trial data and published sources.
The results showed that continuous NAT use led to the highest time spent on low EDSS levels, fewer relapses, reduced years of life lost, and a higher employment rate over 10 years. Early NAT switch (after 1 year) yielded similar outcomes, with lower disease management costs, including indirect and non- disease-modifying therapies (DMTs) medical costs, than delayed switch.
Investigators found that continuous and early switch to NAT improved outcomes and reduced costs, indicating long-term savings.
Source: link.springer.com/article/10.1007/s00415-024-12723-4
