PMID- 37944195
OWN - NLM
STAT- MEDLINE
DCOM- 20231222
LR  - 20240102
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 80
DP  - 2023 Dec
TI  - Benefits of sphingosine-1-phosphate receptor modulators in relapsing MS estimated 
      with a treatment sequence model.
PG  - 105100
LID - S2211-0348(23)00601-6 [pii]
LID - 10.1016/j.msard.2023.105100 [doi]
AB  - BACKGROUND: Three sphingosine-1-phosphate receptor (S1PR) modulators are 
      currently available as disease-modifying therapies (DMTs) for relapsing MS in the 
      Netherlands (i.e. fingolimod, ozanimod and ponesimod). We aimed to identify which 
      S1PR modulator yields the highest benefit from a health-economic and societal 
      perspective during a patient's lifespan. METHODS: Incorporating Dutch DMT list 
      prices, we used the ErasmusMC/iMTA MS model to compare DMT sequences, including 
      S1PR modulators and eight other DMT classes, for treatment-naive patients with 
      relapsing MS in terms of health outcomes (number of lifetime relapses, time to 
      Expanded Disability Status Scale (EDSS) 6, lifetime quality-adjusted life years 
      (QALYs)) and cost-effectiveness (net health benefit (NHB)). We estimated the 
      influence of list price and EDSS progression on cost-effectiveness outcomes. 
      RESULTS: In deterministic and probabilistic analysis, DMT sequences with 
      ponesimod have lower lifetime costs and higher QALYs resulting in a higher 
      average NHB compared to sequences with other S1PR modulators. Ponesimod remains 
      the most cost-effective S1PR modulator when EDSS progression is class-averaged. 
      Given the variable effects on disability progression, list price reductions could 
      make fingolimod but not ozanimod more cost-effective than ponesimod. CONCLUSION: 
      Our model favours ponesimod among the S1PR modulators for the treatment of 
      relapsing MS. This implies that prioritizing ponesimod over other S1PR modulators 
      translates into a more efficacious spending of national healthcare budget without 
      reducing benefit for people with MS. Prioritizing cost-effective choices when 
      counselling patients contributes to affordable and accessible MS care.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Corsten, Cato E A
AU  - Corsten CEA
AD  - MS Center ErasMS, Department of Neurology, Erasmus MC Rotterdam, Doctor 
      Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
FAU - Huygens, Simone A
AU  - Huygens SA
AD  - Huygens & Versteegh, Zwijndrecht, the Netherlands.
FAU - Versteegh, Matthijs M
AU  - Versteegh MM
AD  - Huygens & Versteegh, Zwijndrecht, the Netherlands.
FAU - Wokke, Beatrijs H A
AU  - Wokke BHA
AD  - MS Center ErasMS, Department of Neurology, Erasmus MC Rotterdam, Doctor 
      Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
FAU - Smets, Ide
AU  - Smets I
AD  - MS Center ErasMS, Department of Neurology, Erasmus MC Rotterdam, Doctor 
      Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Electronic address: 
      i.smets@erasmusmc.nl.
FAU - Smolders, Joost
AU  - Smolders J
AD  - MS Center ErasMS, Department of Neurology, Erasmus MC Rotterdam, Doctor 
      Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Department of Immunology, 
      Erasmus MC Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the 
      Netherlands. Electronic address: j.j.f.m.smolders@erasmusmc.nl.
LA  - eng
PT  - Journal Article
DEP - 20231022
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - G926EC510T (Fingolimod Hydrochloride)
RN  - 0 (Sphingosine 1 Phosphate Receptor Modulators)
RN  - 5G7AKV2MKP (ponesimod)
RN  - 0 (Sphingosine-1-Phosphate Receptors)
RN  - 0 (Immunologic Factors)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Humans
MH  - Fingolimod Hydrochloride/therapeutic use
MH  - *Sphingosine 1 Phosphate Receptor Modulators/pharmacology/therapeutic use
MH  - *Multiple Sclerosis, Relapsing-Remitting/drug therapy
MH  - Sphingosine-1-Phosphate Receptors
MH  - Immunologic Factors
MH  - Recurrence
MH  - Cost-Benefit Analysis
MH  - Immunosuppressive Agents
OTO - NOTNLM
OT  - Cost-effectiveness
OT  - Disease-modifying therapy
OT  - Health economics
OT  - Relapsing remitting multiple sclerosis
OT  - Sphingosine-1-phosphate receptor modulators
OT  - Treatment sequence
COIS- Declaration of Competing Interest Cato E.A. Corsten and Beatrijs H.A. Wokke 
      declare no conflicts of interest. Simone A. Huygens and Matthijs M. Versteegh are 
      shareholders of Huygens & Versteegh which conducts research for government 
      organizations and pharmaceutical companies, including research in MS. Ide Smets 
      has received honoraria from Merck and Biogen Idec. Joost Smolders received 
      lecture and/or consultancy fee from Biogen, Merck, Novartis, and Sanofi Genzyme.
EDAT- 2023/11/09 18:42
MHDA- 2023/12/22 06:43
CRDT- 2023/11/09 18:00
PHST- 2022/12/20 00:00 [received]
PHST- 2023/09/08 00:00 [revised]
PHST- 2023/10/21 00:00 [accepted]
PHST- 2023/12/22 06:43 [medline]
PHST- 2023/11/09 18:42 [pubmed]
PHST- 2023/11/09 18:00 [entrez]
AID - S2211-0348(23)00601-6 [pii]
AID - 10.1016/j.msard.2023.105100 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2023 Dec;80:105100. doi: 10.1016/j.msard.2023.105100. 
      Epub 2023 Oct 22.