Supporting the Value of a Disease-Modifying Therapy in Multiple Sclerosis

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Integrated Real-World Clinical and Economic Evaluation of Treatment Alternatives


Our client was able to support the value of their DMT in an increasingly crowded marketplace with an integrated real-world clinical and economic evaluation of MS treatment alternatives. The resulting cost-effectiveness model provided robust scenario analysis capabilities and structural flexibility that met global health technology assessment (HTA) standards.


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.


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.


  • 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.