Economic Analysis for Introduction of Cladribine Tablets as a Treatment for Relapsing Multiple Sclerosis Patients with High Disease Activity in Kuwait

¹Raed Alroughani, ²Samar Farouk Ahmed, ³Amr Abokoura, ⁴Essam Alsultan, ⁵Amir Boshra, ⁵Rawan Alcharif, ⁶Rita Ojeil, ⁷Sujata Basu

¹Department of Medicine, Amiri Hospital, Sharq, Kuwait, Neurology Department, ²Neurology Department, Ibn Sina Hospital, Kuwait, Neuropsychiatry Department, Faculty of Medicine, Minia University, Egypt, ³Neurology Division, Mubarak Alkabeer hospital, Kuwait, ⁴Head of Pharmacy Department, Ibn Sina hospital, Kuwait ⁵Merck Serono Middle East FZ LTD, an affiliate of Merck KgaA, Darmstadt, Germany, ⁶HEOR, IQVIA, Middle East, ⁷HEOR, IQVIA, India.

Introduction/Objective(s):

Multiple sclerosis (MS) is a chronic demyelinating neurological disorder characterized by the loss of sensory and motor functions. In 2019, the estimated prevalence and incidence of MS in Kuwait per 100,000 people was 104.9 and 5.39, respectively. Cladribine tablets are the first oral short-course treatment approved for highly active relapsing multiple sclerosis across various geographies. The objective of the study was to estimate the budget impact (BI) of introducing Cladribine tablets compared to other disease-modifying drugs for the treatment of high-disease activity (HDA) relapsing MS patients from the payer’s perspective in Kuwait.

Material(s) and Method(s):

BI analysis was conducted using an excel-based BI model in the adult population with HDA relapsing MS in Kuwait. Three scenarios, ‘MS Treatments without Cladribine’ and ‘MS Treatments including Cladribine’ and ‘MS Treatments with 100% Cladribine’ were assessed over a five-year time horizon. Model inputs included the total number of RRMS and HDA patients, market shares for the three scenarios, and costs associated with drug acquisition, administration, monitoring, adverse events management, and relapse therapy. All costs were presented in 2021 Kuwaiti Dinars (KWD). Inputs were retrieved from literature and/or obtained from interviews with key experts in Kuwait. All the inputs used in the model were further validated by key experts.

Result(s):

Introducing Cladribine tablets for the treatment of HDA relapsing MS in Kuwait resulted in an estimated decrease in the overall net budget from 4.8% (KWD 984,282) in scenario 2 and up to 28.5% ([RB1] KWD 5,861,086) in scenario 3. The major contributors for cost savings included the drug acquisition costs, expenditure associated with adverse events and rescue treatment.

Conclusion(s):

Introduction of cladribine tablets in Kuwait as a treatment option in HDA relapsing MS patients shows cost-saving from the payer’s perspective. The savings in budget improved with an increase in the cladribine tablets market share.