Integrated Real-World Clinical and Economic Evaluation of Treatment Alternatives

OPPORTUNITY

Disease-modifying therapies (DMTs) have been shown to reduce relapses and delay disability progression for people living with multiple sclerosis (MS). Our client wanted to leverage real-world effectiveness data to compare the long-term clinical and economic value of various DMTs for MS.

CHALLENGE

Analyses of comparative treatment effectiveness—such as studies that evaluate data from real-world registries—are not typically designed to meet the needs of economic evaluations used by payers and reimbursement agencies. Therefore, we needed to design and conduct a comparative effectiveness analysis of treatment alternatives in MS that explicitly accounted for the requirements of established MS cost-effectiveness modeling methods.

OUR APPROACH

• We utilized data from a disease registry including roughly 78,000 patient records from almost 40 countries over nearly 2 decades.
• Our modeling team helped design a real-world effectiveness analysis that created propensity score-matched treatment groups to establish balance among baseline characteristics. All treatments of interest were analyzed separately and in comparison with a common reference group to facilitate extrapolation scenarios in the cost-effectiveness model.
• We integrated the comparative effectiveness outcomes into a cost-effectiveness model aligned with modeling precedent in MS and global HTA requirements. 
• We adapted the original cost-effectiveness model for the United Kingdom to support market access efforts in multiple other countries.