Uso del peginterferone beta-1a nella sclerosi multipla
recidivante-remittente: spesa correlata e aderenza alla terapia nell’ASL Toscana sud est, sede di Grosseto
Giuliano Polichetti, Leonardo Gianluca Lacerenza, Fabio Lena
Objective Relapsing-Remitting Multiple Sclerosis (RRMS) is a chronic autoimmune demyelinating disease, that affects the central nervous system. In Italy the prevalence is 113 cases per 100,000 individuals. The solutions for such pathology are limited, although in the last few years more therapies are being discovered, both as oral or subcutaneous injection form, some being more effective and expensive as well. The majority of the injection drugs are interferon based with weekly administration. One of the latest findings is a subcutaneous injection form called peginterferon beta-1a (Plegridy®), that in its pegilated form has the advantage of requiring only a bi-monthly administration, with obvious benefits for patients such as better compliance. Our goal is to analyze the following data for the Azienda Toscana USL sud est - area of Grosseto: how many patients have been enrolled; the cost of such therapies; the compliance during the first two years of sale.
Methods Consultation of Business Object (BO) software: extraction of data relative to direct supply in different dosages of peginterferon beta-1a and dimethyl fumarate for patients residing in our ASL. Timeframe of reference: November 1st 2015 (first supply) to October 31st 2017. Further elaborations needed to reach the goal described above.
Results Peginterferon beta-1a is indicated in adult patients for the treatment of RRMS. Fourteen patients were enrolled during the period of the study. Thirteen start kits and 169 standard kits were supplied for a total cost of € 147,316 and an average yearly cost of € 10, 803 per patient. Out of 14 patients, only four of them didn’t follow up with us (for unknown reasons), while for the others the compliance was 100%.
Conclusions Undoubtedly, the subcutaneous injection drugs for MS are expensive, and for this reason the ASL should monitor the average yearly cost per patient. On the other side, those drugs are comparable, pricewise, to other therapies such as the ones for oral administration. We suggest a comparison with other subcutaneous injection drugs to assess the cost-benefits ratio, the potential improvement of the quality of the life and the compliance of the patient to the therapy.
Key words: relapsing remitting multiple sclerosis, peginterferon beta-1a, dimethyl fumarate, compliance, adherence to treatment, prescription appropriateness