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I'm often asked where I get much of the information I turn into our Life With Multiple Sclerosis blogs. I use a lot of the same patient advocacy organizations that you do. I also subscribe to some medical journals, and I get alerts from professional sites used by doctors and journalists.
Last week I got an alert from one of those sites telling me about a new report on the cost-benefit ratio of multiple sclerosis (MS) drugs, produced by the Institute for Clinical and Economic Review (ICER) and dated March 6, 2017.
In the report (It's 253 pages, so make the coffee strong), the Institute states that most people living with MS who use disease-modifying therapies (DMTs) are generally happy with the outcomes relative to disease progression and quality-of-life issues (though they feel that quality of life could be addressed better in clinical studies of drugs).
Some MS Drugs Work Better Than Others
The Institute also says that while all of the medications seem to have redeeming qualities for at least a portion of the MS patient population, three medications in particular — Lemtrada (alemtuzumab), Tysabri (natalizumab), and Ocrevus (ocrelizumab) — were "the most effective drugs in reducing relapses, and they were significantly better than the other DMTs."
(Note that Ocrevus is not yet approved for marketing by the U.S. Food and Drug Administration but is widely expected to be approved this month.)
The report also states that those three DMTs seem to be a bit better at staving off disability progression than the others, though not by nearly as wide a margin.
So, why is this not good news? The price.
All MS Drugs Are Expensive. Very Expensive.
The term quality-adjusted life year (QALY) refers to a measure of disease burden that takes into consideration both quality and quantity of life lived. The cost-per-QALY is the cost of an intervention (in this case, a drug) to produce a year of better health.
The ICER report compared the effects of DMTs with what it calls "supportive care" — or being off medication but having assistance where needed.
It finds that using most DMTs costs between $183,300 and $355,300 per additional QALY, depending on which drug you take. That's a pretty big price tag.
The Cost Per Relapse Avoided
Put another way that I found striking, the cost per relapse avoided ranged from $48,787 to a whopping $942,036. That's a lot of money to avoid one relapse.
Another figure that made me sit up and rub my eyes was the cost of an additional year of life that the DMTs appear to afford. If you've ever wanted to know how much an extra 365 days on this earth will cost for a person with MS, it's between $166,077 and $1,684,239 (yes, that's nearly 1.7 million dollars).
There is a lot more for me to digest in this report, as I only got through the 29-page executive summary. I plan to tease out more information as I can. That said, I think I'd have to agree with the Institute's opinion that as far as value goes, MS disease-modifying therapies fall well into the overpriced category.
Wishing you and your family the best of health.
My book, Chef Interrupted, is available on Amazon. Follow me on the Life With MS Facebook page and on Twitter, and subscribe to Life With Multiple Sclerosis.
Photo Illustration: Shutterstock; Getty Images
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