Abstract
Background and purpose: The recent report on Value-of-Treatment (VoT) project highlights the need for early diagnosis-intervention, integrated, seamless care underpinning timely care pathways and access to best treatments. The VoT-multiple-sclerosis (MS) economic case study analysis aimed to estimate the effectiveness/cost-effectiveness of both early treatment and reducing MS risk factors (e.g. smoking and vitamin D insufficiency). Methods: A series of decision analytical modellings were developed and applied to estimate the cost-effectiveness of: (1) reducing the conversion from clinically-isolated-syndrome (CIS) to clinically-definite-MS (CDMS); (2) smoking cessation and increase of 25 hydroxyvitamin D (25(OH)D) serum level. Both (1) and (2) considered socioeconomic impact on averted MS disability progression. Costs were reported for societal and healthcare provider perspectives (pending on data across nations; Euros). Effectiveness was expressed as Quality-Adjusted-Life-Years (QALYs) gains. Long term (25, 30, 40,50-years) and short (one-year) timelines were considered for (1) and (2), respectively. Results: Early treatment was cost-effective for the health care provider and both cost-effective/cost-saving for the society across time-horizons and nations. Smoking cessation and an increase of 25(OH)D in MS patients were both cost-effective/cost-saving across nations. Conclusions: To the best of our knowledge, our work provides the first economic evidence to base appropriate public health interventions to reduce the MS burden in Europe.
Originalsprog | Engelsk |
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Artikelnummer | 103107 |
Tidsskrift | Multiple Sclerosis and Related Disorders |
Vol/bind | 54 |
ISSN | 2211-0348 |
DOI | |
Status | Udgivet - 2021 |
Bibliografisk note
Funding Information:As part of the “Value of Treatment (VoT) for Brain Disorders” Project, this work was financially supported by the European Brain Council.
Funding Information:
This study is part of the Value of Treatment (VoT) Project ( EBC Report, 2017 ); promoted by the European Academy of Neurology (EAN) and funded by the European Brain Council (EBC) and which was aimed to define the ‘value’ of treatment strategies of nine different brain disorders in Europe. Specifically, within the MS case study, the disease care pathway was analysed to highlight the major challenges and needs in the overall patient's disease course. Most importantly, key treatment gaps (e.g., late intervention with DMDs) as well as the detrimental impact of some lifestyle factors were considered for in-depth economic analysis aimed to identify the potential economic benefit from controlling these factors and closing such gaps.
Funding Information:
This work is part of a series of case studies covering nine neurological and psychiatric conditions, conducted within the ?Value of Treatment (VoT) for Brain Disorders? research project promoted by the European Brain Council and European Academy of Neurology. The authors are grateful to Dr. Monica Moroni MD, School of Medicine, University of Ferrara, Italy for precious assistance in the literature search.
Publisher Copyright:
© 2021