Cost-effectiveness of ofatumumab for the treatment of relapsing forms of multiple sclerosis in the United Arab Emirates.

Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, associated with demyelination and inflammation. Relapsing forms of MS (RMS) encompass all patients with MS experiencing relapses. While there is currently no cure for MS, the introduction of several disease-modifying therapies (DMTs) has significantly reduced the risk of relapse and disability in patients with MS. There is a high unmet need for an easy-to-administer DMT that can be used early in the treatment pathway.

Objectives: This study aimed to evaluate the cost-effectiveness of ofatumumab compared with other commonly used DMTs for the treatment of RMS from a health payer perspective in the United Arab Emirates (UAE).

Design: A cost-effectiveness analysis.

Methods: A Markov model, based on expanded disability status scale (EDSS) health states, was developed using the UAE payer's perspective and a 65-year time horizon. The baseline patient distribution across the EDSS states was aligned to the population of ASCLEPIOS I and II trials. The British Columbia database informed natural history transition probabilities. Treatment effects were applied by delaying disability progression and reducing the number of relapses and were sourced from a network meta-analysis. The health care resource utilization was derived from interviews with local experts, who also validated the model structure and comparators, and utility inputs from published studies. In the absence of an officially defined willingness-to-pay threshold in the UAE, it was assumed to be United Arab Emirates Dirham (AED) 369,854 per quality-adjusted life-year (QALY), which is twice the UAE gross domestic product per capita.

Results: Base-case results indicated that ofatumumab was dominant over ocrelizumab, dimethyl fumarate, fingolimod, and natalizumab intravenous; was more cost-effective compared with teriflunomide, fingolimod (generic), glatiramer acetate, interferons, and best supportive care; and resulted in an incremental cost-effectiveness ratio of AED 713,068 per QALY versus cladribine. Sensitivity analyses were in line with the results of the base-case analysis.

Conclusion: From the UAE payer's perspective, ofatumumab could be a cost-effective treatment alternative for patients with RMS.