Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom

Spelman, Tim|||0000-0001-9204-3216; Herring, William L.|||0000-0001-8222-9914; Acosta, Carlos|||0000-0002-7257-8675; Hyde, Robert|||0000-0002-3035-5369; Jokubaitis, V.|||0000-0002-3942-4340; Pucci, Eugenio; Lugaresi, Alessandra|||0000-0003-2902-5589; Laureys, Guy; Kubala Havrdova, Eva|||0000-0002-9543-4359; Horáková, Dana; Izquierdo, Guillermo|||0000-0002-6340-5609; Eichau Madueño, Sara; Ozakbas, Serkan; Alroughani, Raed A.; Kalincik, Tomas|||0000-0003-3778-1376; Duquette, Pierre Pascal; Girard, Marc; Petersen, Thor|||0000-0001-5633-2600; Patti, Francesco|||0000-0002-6923-0846; Csepany, Tunde|||0000-0002-8305-3209; Granella, Franco; Grand'Maison, François; Ferraro, Diana; Karabudak, Rana; José Sà, Maria; Trojano, Maria|||0000-0002-6329-8946; van Pesch, Vincent|||0000-0003-2885-9004; van Wijmeersch, Bart; Cartechini, Elisabetta; McCombe, Pamela A.; Gerlach, Oliver H. H.; Spitaleri, Daniele Litterio A.; Rozsa, Csilla S.; Hodgkinson, Suzanne J.; Bergamaschi, Roberto; Gouider, Riadh; Soysal, Aysun; Castillo-Triviño, Tamara|||0000-0002-9249-3185; Prevost, Julie; Garber, Justin Y.; de Gans, Koen; Ampapa, Radek; Simo, Magdolna; Sánchez Menoyo, José Luis|||0000-0003-2634-8294; Iuliano, Gerardo; Sas, Attila; van der Walt, A.; John, Nevin; Gray, Orla M.; Hughes, Stella E.; De Luca, Giovanna|||0000-0002-7693-2256; Onofrj, Marco|||0000-0002-0480-2495; Buzzard, Katherine A.; Skibina, Olga G.; Terzi, Murat; Slee, Mark|||0000-0003-4323-2453; Solaro, Claudio Marcello|||0000-0002-6713-4623; Oreja-Guevara, Celia|||0000-0002-9221-5716; Ramo-Tello, Cristina|||0000-0001-8643-5053; Fragoso, Yára Dadalti; Shaygannejad, Vahid; Moore, Fraser G. A.; Rajda, Cecília; Agüera-Morales, Eduardo|||0000-0002-8604-2054; Butzkueven, Helmut|||0000-0003-3940-8727

Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom

Aim: To evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS). Methods: Real-world data from the MSBase R...

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Autores:	Spelman, Tim\|\|\|0000-0001-9204-3216, Herring, William L.\|\|\|0000-0001-8222-9914, Acosta, Carlos\|\|\|0000-0002-7257-8675, Hyde, Robert\|\|\|0000-0002-3035-5369, Jokubaitis, V.\|\|\|0000-0002-3942-4340, Pucci, Eugenio, Lugaresi, Alessandra\|\|\|0000-0003-2902-5589, Laureys, Guy, Kubala Havrdova, Eva\|\|\|0000-0002-9543-4359, Horáková, Dana, Izquierdo, Guillermo\|\|\|0000-0002-6340-5609, Eichau Madueño, Sara, Ozakbas, Serkan, Alroughani, Raed A., Kalincik, Tomas\|\|\|0000-0003-3778-1376, Duquette, Pierre Pascal, Girard, Marc, Petersen, Thor\|\|\|0000-0001-5633-2600, Patti, Francesco\|\|\|0000-0002-6923-0846, Csepany, Tunde\|\|\|0000-0002-8305-3209, Granella, Franco, Grand'Maison, François, Ferraro, Diana, Karabudak, Rana, José Sà, Maria, Trojano, Maria\|\|\|0000-0002-6329-8946, van Pesch, Vincent\|\|\|0000-0003-2885-9004, van Wijmeersch, Bart, Cartechini, Elisabetta, McCombe, Pamela A., Gerlach, Oliver H. H., Spitaleri, Daniele Litterio A., Rozsa, Csilla S., Hodgkinson, Suzanne J., Bergamaschi, Roberto, Gouider, Riadh, Soysal, Aysun, Castillo-Triviño, Tamara\|\|\|0000-0002-9249-3185, Prevost, Julie, Garber, Justin Y., de Gans, Koen, Ampapa, Radek, Simo, Magdolna, Sánchez Menoyo, José Luis\|\|\|0000-0003-2634-8294, Iuliano, Gerardo, Sas, Attila, van der Walt, A., John, Nevin, Gray, Orla M., Hughes, Stella E., De Luca, Giovanna\|\|\|0000-0002-7693-2256, Onofrj, Marco\|\|\|0000-0002-0480-2495, Buzzard, Katherine A., Skibina, Olga G., Terzi, Murat, Slee, Mark\|\|\|0000-0003-4323-2453, Solaro, Claudio Marcello\|\|\|0000-0002-6713-4623, Oreja-Guevara, Celia\|\|\|0000-0002-9221-5716, Ramo-Tello, Cristina\|\|\|0000-0001-8643-5053, Fragoso, Yára Dadalti, Shaygannejad, Vahid, Moore, Fraser G. A., Rajda, Cecília, Agüera-Morales, Eduardo\|\|\|0000-0002-8604-2054, Butzkueven, Helmut\|\|\|0000-0003-3940-8727
Tipo de recurso:	artículo
Fecha de publicación:	2024
País:	España
Institución:	Universitat Autònoma de Barcelona
Repositorio:	Dipòsit Digital de Documents de la UAB
Idioma:	inglés
OAI Identifier:	oai:ddd.uab.cat:311627
Acceso en línea:	https://ddd.uab.cat/record/311627 https://dx.doi.org/urn:doi:10.1080/13696998.2023.2293379
Access Level:	acceso abierto
Palabra clave:	Multiple sclerosis Natalizumab Fingolimod Real-world data Comparative effectiveness Cost-effectiveness

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oai_identifier_str	oai:ddd.uab.cat:311627
network_acronym_str	ES
network_name_str	España
repository_id_str
dc.title.none.fl_str_mv	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
title	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
spellingShingle	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom Spelman, Tim\|\|\|0000-0001-9204-3216 Multiple sclerosis Natalizumab Fingolimod Real-world data Comparative effectiveness Cost-effectiveness
title_short	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
title_full	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
title_fullStr	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
title_full_unstemmed	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
title_sort	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom
dc.creator.none.fl_str_mv	Spelman, Tim\|\|\|0000-0001-9204-3216 Herring, William L.\|\|\|0000-0001-8222-9914 Acosta, Carlos\|\|\|0000-0002-7257-8675 Hyde, Robert\|\|\|0000-0002-3035-5369 Jokubaitis, V.\|\|\|0000-0002-3942-4340 Pucci, Eugenio Lugaresi, Alessandra\|\|\|0000-0003-2902-5589 Laureys, Guy Kubala Havrdova, Eva\|\|\|0000-0002-9543-4359 Horáková, Dana Izquierdo, Guillermo\|\|\|0000-0002-6340-5609 Eichau Madueño, Sara Ozakbas, Serkan Alroughani, Raed A. Kalincik, Tomas\|\|\|0000-0003-3778-1376 Duquette, Pierre Pascal Girard, Marc Petersen, Thor\|\|\|0000-0001-5633-2600 Patti, Francesco\|\|\|0000-0002-6923-0846 Csepany, Tunde\|\|\|0000-0002-8305-3209 Granella, Franco Grand'Maison, François Ferraro, Diana Karabudak, Rana José Sà, Maria Trojano, Maria\|\|\|0000-0002-6329-8946 van Pesch, Vincent\|\|\|0000-0003-2885-9004 van Wijmeersch, Bart Cartechini, Elisabetta McCombe, Pamela A. Gerlach, Oliver H. H. Spitaleri, Daniele Litterio A. Rozsa, Csilla S. Hodgkinson, Suzanne J. Bergamaschi, Roberto Gouider, Riadh Soysal, Aysun Castillo-Triviño, Tamara\|\|\|0000-0002-9249-3185 Prevost, Julie Garber, Justin Y. de Gans, Koen Ampapa, Radek Simo, Magdolna Sánchez Menoyo, José Luis\|\|\|0000-0003-2634-8294 Iuliano, Gerardo Sas, Attila van der Walt, A. John, Nevin Gray, Orla M. Hughes, Stella E. De Luca, Giovanna\|\|\|0000-0002-7693-2256 Onofrj, Marco\|\|\|0000-0002-0480-2495 Buzzard, Katherine A. Skibina, Olga G. Terzi, Murat Slee, Mark\|\|\|0000-0003-4323-2453 Solaro, Claudio Marcello\|\|\|0000-0002-6713-4623 Oreja-Guevara, Celia\|\|\|0000-0002-9221-5716 Ramo-Tello, Cristina\|\|\|0000-0001-8643-5053 Fragoso, Yára Dadalti Shaygannejad, Vahid Moore, Fraser G. A. Rajda, Cecília Agüera-Morales, Eduardo\|\|\|0000-0002-8604-2054 Butzkueven, Helmut\|\|\|0000-0003-3940-8727
author	Spelman, Tim\|\|\|0000-0001-9204-3216
author_facet	Spelman, Tim\|\|\|0000-0001-9204-3216 Herring, William L.\|\|\|0000-0001-8222-9914 Acosta, Carlos\|\|\|0000-0002-7257-8675 Hyde, Robert\|\|\|0000-0002-3035-5369 Jokubaitis, V.\|\|\|0000-0002-3942-4340 Pucci, Eugenio Lugaresi, Alessandra\|\|\|0000-0003-2902-5589 Laureys, Guy Kubala Havrdova, Eva\|\|\|0000-0002-9543-4359 Horáková, Dana Izquierdo, Guillermo\|\|\|0000-0002-6340-5609 Eichau Madueño, Sara Ozakbas, Serkan Alroughani, Raed A. Kalincik, Tomas\|\|\|0000-0003-3778-1376 Duquette, Pierre Pascal Girard, Marc Petersen, Thor\|\|\|0000-0001-5633-2600 Patti, Francesco\|\|\|0000-0002-6923-0846 Csepany, Tunde\|\|\|0000-0002-8305-3209 Granella, Franco Grand'Maison, François Ferraro, Diana Karabudak, Rana José Sà, Maria Trojano, Maria\|\|\|0000-0002-6329-8946 van Pesch, Vincent\|\|\|0000-0003-2885-9004 van Wijmeersch, Bart Cartechini, Elisabetta McCombe, Pamela A. Gerlach, Oliver H. H. Spitaleri, Daniele Litterio A. Rozsa, Csilla S. Hodgkinson, Suzanne J. Bergamaschi, Roberto Gouider, Riadh Soysal, Aysun Castillo-Triviño, Tamara\|\|\|0000-0002-9249-3185 Prevost, Julie Garber, Justin Y. de Gans, Koen Ampapa, Radek Simo, Magdolna Sánchez Menoyo, José Luis\|\|\|0000-0003-2634-8294 Iuliano, Gerardo Sas, Attila van der Walt, A. John, Nevin Gray, Orla M. Hughes, Stella E. De Luca, Giovanna\|\|\|0000-0002-7693-2256 Onofrj, Marco\|\|\|0000-0002-0480-2495 Buzzard, Katherine A. Skibina, Olga G. Terzi, Murat Slee, Mark\|\|\|0000-0003-4323-2453 Solaro, Claudio Marcello\|\|\|0000-0002-6713-4623 Oreja-Guevara, Celia\|\|\|0000-0002-9221-5716 Ramo-Tello, Cristina\|\|\|0000-0001-8643-5053 Fragoso, Yára Dadalti Shaygannejad, Vahid Moore, Fraser G. A. Rajda, Cecília Agüera-Morales, Eduardo\|\|\|0000-0002-8604-2054 Butzkueven, Helmut\|\|\|0000-0003-3940-8727
author_role	author
author2	Herring, William L.\|\|\|0000-0001-8222-9914 Acosta, Carlos\|\|\|0000-0002-7257-8675 Hyde, Robert\|\|\|0000-0002-3035-5369 Jokubaitis, V.\|\|\|0000-0002-3942-4340 Pucci, Eugenio Lugaresi, Alessandra\|\|\|0000-0003-2902-5589 Laureys, Guy Kubala Havrdova, Eva\|\|\|0000-0002-9543-4359 Horáková, Dana Izquierdo, Guillermo\|\|\|0000-0002-6340-5609 Eichau Madueño, Sara Ozakbas, Serkan Alroughani, Raed A. Kalincik, Tomas\|\|\|0000-0003-3778-1376 Duquette, Pierre Pascal Girard, Marc Petersen, Thor\|\|\|0000-0001-5633-2600 Patti, Francesco\|\|\|0000-0002-6923-0846 Csepany, Tunde\|\|\|0000-0002-8305-3209 Granella, Franco Grand'Maison, François Ferraro, Diana Karabudak, Rana José Sà, Maria Trojano, Maria\|\|\|0000-0002-6329-8946 van Pesch, Vincent\|\|\|0000-0003-2885-9004 van Wijmeersch, Bart Cartechini, Elisabetta McCombe, Pamela A. Gerlach, Oliver H. H. Spitaleri, Daniele Litterio A. Rozsa, Csilla S. Hodgkinson, Suzanne J. Bergamaschi, Roberto Gouider, Riadh Soysal, Aysun Castillo-Triviño, Tamara\|\|\|0000-0002-9249-3185 Prevost, Julie Garber, Justin Y. de Gans, Koen Ampapa, Radek Simo, Magdolna Sánchez Menoyo, José Luis\|\|\|0000-0003-2634-8294 Iuliano, Gerardo Sas, Attila van der Walt, A. John, Nevin Gray, Orla M. Hughes, Stella E. De Luca, Giovanna\|\|\|0000-0002-7693-2256 Onofrj, Marco\|\|\|0000-0002-0480-2495 Buzzard, Katherine A. Skibina, Olga G. Terzi, Murat Slee, Mark\|\|\|0000-0003-4323-2453 Solaro, Claudio Marcello\|\|\|0000-0002-6713-4623 Oreja-Guevara, Celia\|\|\|0000-0002-9221-5716 Ramo-Tello, Cristina\|\|\|0000-0001-8643-5053 Fragoso, Yára Dadalti Shaygannejad, Vahid Moore, Fraser G. A. Rajda, Cecília Agüera-Morales, Eduardo\|\|\|0000-0002-8604-2054 Butzkueven, Helmut\|\|\|0000-0003-3940-8727
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Multiple sclerosis Natalizumab Fingolimod Real-world data Comparative effectiveness Cost-effectiveness
topic	Multiple sclerosis Natalizumab Fingolimod Real-world data Comparative effectiveness Cost-effectiveness
description	Aim: To evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS). Methods: Real-world data from the MSBase Registry were obtained for patients with RES-RRMS who were previously either naive to disease-modifying therapies or had been treated with interferon-based therapies, glatiramer acetate, dimethyl fumarate, or teriflunomide (collectively known as BRACETD). Matched cohorts were selected by 3-way multinomial propensity score matching, and the annualized relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M) were compared between treatment groups. Comparative effectiveness results were used in a cost-effectiveness model comparing natalizumab and fingolimod, using an established Markov structure over a lifetime horizon with health states based on the Expanded Disability Status Scale. Additional model data sources included the UK MS Survey 2015, published literature, and publicly available sources. Results: In the comparative effectiveness analysis, we found a significantly lower ARR for patients starting natalizumab compared with fingolimod (rate ratio [RR] = 0.65; 95% confidence interval [CI], 0.57-0.73) or BRACETD (RR = 0.46; 95% CI, 0.42-0.53). Similarly, CDI6M was higher for patients starting natalizumab compared with fingolimod (hazard ratio [HR] = 1.25; 95% CI, 1.01-1.55) and BRACETD (HR = 1.46; 95% CI, 1.16-1.85). In patients starting fingolimod, we found a lower ARR (RR = 0.72; 95% CI, 0.65-0.80) compared with starting BRACETD, but no difference in CDI6M (HR = 1.17; 95% CI, 0.91-1.50). Differences in CDW6M were not found between the treatment groups. In the base-case cost-effectiveness analysis, natalizumab dominated fingolimod (0.302 higher quality-adjusted life-years [QALYs] and £17,141 lower predicted lifetime costs). Similar cost-effectiveness results were observed across sensitivity analyses. Conclusions: This MSBase Registry analysis suggests that natalizumab improves clinical outcomes when compared with fingolimod, which translates to higher QALYs and lower costs in UK patients with RES-RRMS.
publishDate	2024
dc.date.none.fl_str_mv	2 2024-01-01 2024 2024-01-01
dc.type.none.fl_str_mv	Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv	info:eu-repo/semantics/article
format	article
dc.identifier.none.fl_str_mv	https://ddd.uab.cat/record/311627 https://dx.doi.org/urn:doi:10.1080/13696998.2023.2293379
url	https://ddd.uab.cat/record/311627 https://dx.doi.org/urn:doi:10.1080/13696998.2023.2293379
dc.language.none.fl_str_mv	Inglés eng
language_invalid_str_mv	Inglés
language	eng
dc.rights.none.fl_str_mv	open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.source.none.fl_str_mv	reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona
instname_str	Universitat Autònoma de Barcelona
reponame_str	Dipòsit Digital de Documents de la UAB
collection	Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling	Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United KingdomSpelman, Tim\|\|\|0000-0001-9204-3216Herring, William L.\|\|\|0000-0001-8222-9914Acosta, Carlos\|\|\|0000-0002-7257-8675Hyde, Robert\|\|\|0000-0002-3035-5369Jokubaitis, V.\|\|\|0000-0002-3942-4340Pucci, EugenioLugaresi, Alessandra\|\|\|0000-0003-2902-5589Laureys, GuyKubala Havrdova, Eva\|\|\|0000-0002-9543-4359Horáková, DanaIzquierdo, Guillermo\|\|\|0000-0002-6340-5609Eichau Madueño, SaraOzakbas, SerkanAlroughani, Raed A.Kalincik, Tomas\|\|\|0000-0003-3778-1376Duquette, Pierre PascalGirard, MarcPetersen, Thor\|\|\|0000-0001-5633-2600Patti, Francesco\|\|\|0000-0002-6923-0846Csepany, Tunde\|\|\|0000-0002-8305-3209Granella, FrancoGrand'Maison, FrançoisFerraro, DianaKarabudak, RanaJosé Sà, MariaTrojano, Maria\|\|\|0000-0002-6329-8946van Pesch, Vincent\|\|\|0000-0003-2885-9004van Wijmeersch, BartCartechini, ElisabettaMcCombe, Pamela A.Gerlach, Oliver H. H.Spitaleri, Daniele Litterio A.Rozsa, Csilla S.Hodgkinson, Suzanne J.Bergamaschi, RobertoGouider, RiadhSoysal, AysunCastillo-Triviño, Tamara\|\|\|0000-0002-9249-3185Prevost, JulieGarber, Justin Y.de Gans, KoenAmpapa, RadekSimo, MagdolnaSánchez Menoyo, José Luis\|\|\|0000-0003-2634-8294Iuliano, GerardoSas, Attilavan der Walt, A.John, NevinGray, Orla M.Hughes, Stella E.De Luca, Giovanna\|\|\|0000-0002-7693-2256Onofrj, Marco\|\|\|0000-0002-0480-2495Buzzard, Katherine A.Skibina, Olga G.Terzi, MuratSlee, Mark\|\|\|0000-0003-4323-2453Solaro, Claudio Marcello\|\|\|0000-0002-6713-4623Oreja-Guevara, Celia\|\|\|0000-0002-9221-5716Ramo-Tello, Cristina\|\|\|0000-0001-8643-5053Fragoso, Yára DadaltiShaygannejad, VahidMoore, Fraser G. A.Rajda, CecíliaAgüera-Morales, Eduardo\|\|\|0000-0002-8604-2054Butzkueven, Helmut\|\|\|0000-0003-3940-8727Multiple sclerosisNatalizumabFingolimodReal-world dataComparative effectivenessCost-effectivenessAim: To evaluate the real-world comparative effectiveness and the cost-effectiveness, from a UK National Health Service perspective, of natalizumab versus fingolimod in patients with rapidly evolving severe relapsing-remitting multiple sclerosis (RES-RRMS). Methods: Real-world data from the MSBase Registry were obtained for patients with RES-RRMS who were previously either naive to disease-modifying therapies or had been treated with interferon-based therapies, glatiramer acetate, dimethyl fumarate, or teriflunomide (collectively known as BRACETD). Matched cohorts were selected by 3-way multinomial propensity score matching, and the annualized relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M) were compared between treatment groups. Comparative effectiveness results were used in a cost-effectiveness model comparing natalizumab and fingolimod, using an established Markov structure over a lifetime horizon with health states based on the Expanded Disability Status Scale. Additional model data sources included the UK MS Survey 2015, published literature, and publicly available sources. Results: In the comparative effectiveness analysis, we found a significantly lower ARR for patients starting natalizumab compared with fingolimod (rate ratio [RR] = 0.65; 95% confidence interval [CI], 0.57-0.73) or BRACETD (RR = 0.46; 95% CI, 0.42-0.53). Similarly, CDI6M was higher for patients starting natalizumab compared with fingolimod (hazard ratio [HR] = 1.25; 95% CI, 1.01-1.55) and BRACETD (HR = 1.46; 95% CI, 1.16-1.85). In patients starting fingolimod, we found a lower ARR (RR = 0.72; 95% CI, 0.65-0.80) compared with starting BRACETD, but no difference in CDI6M (HR = 1.17; 95% CI, 0.91-1.50). Differences in CDW6M were not found between the treatment groups. In the base-case cost-effectiveness analysis, natalizumab dominated fingolimod (0.302 higher quality-adjusted life-years [QALYs] and £17,141 lower predicted lifetime costs). Similar cost-effectiveness results were observed across sensitivity analyses. Conclusions: This MSBase Registry analysis suggests that natalizumab improves clinical outcomes when compared with fingolimod, which translates to higher QALYs and lower costs in UK patients with RES-RRMS. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/311627https://dx.doi.org/urn:doi:10.1080/13696998.2023.2293379reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3116272026-06-06T12:50:31Z
score	15,811543

Comparative effectiveness and cost-effectiveness of natalizumab and fingolimod in rapidly evolving severe relapsing-remitting multiple sclerosis in the United Kingdom

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