[Treatment of multiple sclerosis with interferonb: an appraisal of cost effectiveness and quality of life] 2000;68:144-9
The use of beta interferon to treat multiple sclerosis (MS) may not be good value for money, finds research published in the Journal of Neurology, Neurosurgery, and Psychiatry. The authors drew their conclusions not just on the issue of cost, but also on the quality of life gains among those taking the drug.
The treatment license of beta interferon was extended last year to include secondary progressive MS; the drug is soon to be reviewed by the National Institute for Clinical Excellence (NICE). "Postcode" allocation of the drug has caused some controversy.
The experiences of 102 people with relapsing-remitting MS, information from published trials, and quality of life and cost data were used to construct a cost effectiveness model for beta interferon. The effects of relapses can last over several months. Quality of life data were based on recognised measures used to score a range of physical, emotional, and social functions, including pain levels, mental state, and sexual activity among others. Costs included inpatient, outpatient and day care costs, as well as drugs and tests.
Beta interferon produced important short term improvements in quality of life for people with MS, but these tended to be infrequent. And the costs of the drug outweighed the savings made. Each relapse avoided cost £28,700. Set against quality of life years gained - that is, the number of years lived free of disease - the costs translated as £809,000 for every year, or £328,300 per year, allowing for the progressive nature of the disease over five years.
Quality of life is very important for people with MS, say the authors, but the improvements effected by beta interferon were short term and did not translate into long term benefits. The monies used for the drug might be better spent on other MS services or on conditions that would result in greater benefits for larger numbers of people, they say.
Contact: Dr Paul McNamee, Department of Epidemiology and Public Health, University of Newcastle upon Tyne.