Introduction: Alemtuzumab is an efficacious treatment for active and highly active remitting-relapsing multiple sclerosis (RRMS). While beneficial budget impact and cost-effectiveness of alemtuzumab has been demonstrated elsewhere, no published health economic evaluations or technology assessments have examined alemtuzumab in the Finnish setting. We estimated potential net budget impact of alemtuzumab in the treatment of adult Finnish patients with highly active RRMS.

Materials and methods: Budget impact was assessed with a Finnish static cohort model, reported within PICOSTEPS framework. In the base case modelling two identical RRMS patients are assigned to the intervention (alemtuzumab) or comparator (fingolimod, natalizumab – most relevant and widely used treatment alternatives) and are followed for the modelled 5-year time period (2019–23). Treatment switching, drop-out or mortality were not considered. The primary outcomes were the total cumulative budgets and net budget impact (differences in cumulative budgets) per patient. One- and multi-way deterministic sensitivity analyses were carried out. To examine whether net budget-impacts are associated with differences in the clinical outcomes, number of relapses experienced and proportion of patients remaining free of disease worsening were modelled as secondary clinical outcomes, based on published clinical trial data and network meta-analysis.

Results: Alemtuzumab was budget-saving on the fourth and on the second year compared to fingolimod and natalizumab, respectively. Modelled cumulative 5-year budget savings were €26,294 and €100,789 per patient, respectively. Treatment with alemtuzumab also resulted in better modelled clinical outcomes than either comparator, implying the budget-savings are not associated with poorer clinical outcomes.

Conclusions: The present study, with support of previous findings from foreign settings, indicate that alemtuzumab is budget-saving alternative to fingolimod and natalizumab in treatment of highly active RRMS in Finland.