Cost-effective treatment for multiple sclerosis Kesimpta: Canadian study

Kesimpta (ofatumumab) is more cost-effective than nearly all other approved first-line treatments for relapsing-remitting multiple sclerosis (RRMS), according to the results of a recent study conducted in Canada.

Moogeh Baharnoori, MD, M.Sc., and his Canadian colleagues assessed the cost-effectiveness of Kesimpta and other therapies as well as best supportive care.

Their results, published in PharmacoEconomy-Open in September, showed that among the first-line therapies indicated for RRMS, Kesimpta was dominant (more effective and less expensive) over Aubagio (teriflunomide), interferons, Tecfidera (dimethyl fumarate) and Ocrevus (ocrelizumab).

“From the perspective of the Canadian public health care system, ofatumumab (Kesimpta) is cost-effective versus all currently approved and reimbursed disease-modifying therapies (DMTs) for the treatment of relapsing-remitting multiple sclerosis (RRMS). ), and dominant over all disease-modifying treatments. therapies with a first-line indication, with the exception of glatiramer acetate,” the “key points” call said in the article.

Unlike other monoclonal antibodies, which are administered intravenously, Kesimpta – the article used the generic name – is administered with a subcutaneous injection which can be self-administered at home, allowing greater patient independence , reduced use of health care resources and access to treatment. in areas that are not close to infusion facilities, she said.

Kesimpta is approved in Canada for the initial treatment of RRMS, but is often reserved for patients with more aggressive disease, Baharnoori noted in the PharmacoEconomicrophones Open article.

Baharnoori is Medical Director of the Multiple Sclerosis Clinic in Kingston and Assistant Professor of Neurology in the Department of Medicine at Queen’s University in Kingston, Ont. The study was funded by Novartis Pharmaceutical Canada. Novartis manufactures and markets Kesimpta.

Compared to glatiramer acetate (Copaxone, other brand names) and best supportive care, ofatumumab had incremental cost-effectiveness ratios (ICERs) of C$24,189 per quality-adjusted life year (QALY ) and $28,014/QALY, respectively, according to Baharnoori and colleagues.

At a willingness-to-pay threshold of $50,000/QALY, ofatumumab had a 64.3% probability of being cost-effective. Among second-line therapies (scenario analysis), ofatumumab dominated natalizumab and fingolimod and resulted in an ICER of $50,969 compared to cladribine.

Kesimpta is approved in Canada for the initial treatment of RRMS, but is often reserved for patients with more aggressive disease, Baharnoor noted in the PharmacoEconomicrophones Open article.

In Canada, five disease-modifying treatments (DMTs) have high efficacy (average reduction in relapses >50%): Gilenya (fingolimod) and cladribine (Mavenclad, others), which are oral medications, and injectable monoclonal antibodies, including Tysabri (natalizumab), Ocrevus and Lemtrada (alemtuzumab), according to Baharnoori.

“Evidence suggests that patients have better disease outcomes (i.e. slower disease progression and reduced long-term disability) when more effective treatments are initiated earlier in the course disease,” Baharnoori said. “However, most of the higher efficacy DMTs are associated with an increased risk of adverse events, limiting treatment to patients with persistent or high baseline disease activity due to a suboptimal response to other DMTs. “

About Antoine L. Cassell

Check Also

A life-saving treatment on the other side of the world

TAKING FLIGHT: Sarah McDowell has been battling multiple sclerosis for nearly five years and hopes …