Cost effectiveness of different treatment strategies with natalizumab for pregnant women with Multiple Sclerosis

Walbaum, Magdalena, Madhukar, Anushka, Dobson, Ruth, Cyhlarova, Eva, Castro‑Aldrete, Laura, Santuccione Chadha, Antonella and Knapp, Martin (2025) Cost effectiveness of different treatment strategies with natalizumab for pregnant women with Multiple Sclerosis. Journal of Neurology, 272 (1). p. 93. ISSN 0340-5354

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Abstract

BACKGROUND: The management of multiple sclerosis (MS) during pregnancy poses significant challenges. This study aimed to evaluate the cost-effectiveness of three natalizumab treatment strategies during pregnancy from the UK healthcare system's perspective. METHODS: A Markov model was developed to assess the health outcomes and costs associated with three treatment strategies: continuous natalizumab treatment throughout pregnancy, treatment until the first trimester followed by discontinuation, and discontinuation at conception with resumption post-pregnancy. The model incorporated data on relapse rates, disability progression, costs and quality-adjusted life years (QALYs). Sensitivity analyses were conducted. RESULTS: Continuing natalizumab throughout pregnancy was the most cost-effective strategy, yielding the highest incremental QALY gains and the lowest incremental cost per QALY (£1713 per QALY), with a net monetary benefit of £743. The sensitivity analyses confirmed the robustness of these findings and the use of generic or biosimilar forms of natalizumab further reinforced the cost-effectiveness of continuous treatment, with the biosimilar option proving cost-saving. CONCLUSION: Continuing natalizumab treatment throughout pregnancy is the most cost-effective approach for managing MS in pregnant women. These findings should inform clinical guidelines and support healthcare providers and women with MS planning their family in making evidence-based decisions to improve the management of MS during pregnancy.

Item Type:	Article
Additional Information:	© 2024 The Authors
Divisions:	Care Policy and Evaluation Centre Health Policy
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RG Gynecology and obstetrics
Date Deposited:	12 Sep 2024 10:06
Last Modified:	26 Sep 2025 23:28
URI:	http://eprintstest.lse.ac.uk/id/eprint/125400

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