Cost-Utility Analysis (cua) Of First-Line Disease-Modifying Treatments (DMT) Versus Best Supportive Care (Bsc) In Finnish Relapsing-Remitting Multiple Sclerosis (RRMS) Patients.

Background Multiple sclerosis (MS) is a chronic, progressive, immune-mediated, neurodegenerative disease of the central nervous system, accumulating patient’s disability over time and causing significant human and economic burden. Approximately 80-90% of the incident MS cases are relapsing-remitting MS (RRMS) characterised by phases of remission and relapse. Important goals of the disease-modifying drug treatment (DMT) in MS are to arrest or slow the accumulation of disability (measured on the Expanded Disability Status Scale, EDSS) and delay progression of the disease to secondary progressive multiple sclerosis (SPMS). Based on the literature and Finnish register data, there is an economic and clinical unmet need for more safe and effective RRMS treatments. Currently widely used injectable DMTs impose limitations in tolerability and safety. Adverse events (AE) including e.g. injection-site or skin reactions, myalgia, fever, influenza-like symptoms, asthenia, chills and neutralizing antibodies are common and they often prevent patients from continuing DMTs. Teriflunomide (Aubagio® 14mg) is oral once daily administered immunomodulatory DMT indicated for adult RRMS patients. It is effective and well-tolerated with a manageable safety profile. Recently, a basic reimbursement for confirmed RRMS in adults was granted for Aubagio® in Finland. No Finnish cost-effectiveness analysis of MS DMTs has been published.