Table 46: Univariate Sensitivity Analysis Regarding Cost of Relapse Cost per relapse = $1,405 Grima et al.74 ICUR versus Treatment Total Cost Total QALYs glatiramer Sequential ICUR acetate Glatiramer acetate $288,507 11.272 Ref Ref (Copaxone) Interferon beta-1b $299,930 11.376 $109,519 $109,519 (Extavia) Dimethyl fumarate $332,772 11.442 $261,092 $503,474 (Tecfidera) Natalizumab (Tysabri) $459,081 11.580 $554,068 $913,177 Dominated treatments Dominated by interferon Interferon beta-1b $313,300 11.376 $237,687 beta-1b 250 mcg (Betaseron) (Extavia) Dominated by interferon Interferon beta-1a 22 beta-1b 250 mcg $316,087 11.187 Dominated mcg (Rebif) (Extavia) and glatiramer acetate Dominated by interferon Interferon beta-1a beta-1b 250 mcg $319,267 11.167 Dominated (Avonex) (Extavia) and glatiramer acetate Dominated by interferon beta-1b 250 mcg Interferon beta-1a 44 $344,575 11.262 Dominated (Extavia), glatiramer mcg (Rebif) acetate and dimethyl fumarate Dominated by dimethyl Fingolimod (Gilenya) $389,409 11.422 $673,157 fumarate Cost per relapse = $6,402 Karampampa et al.75 Glatiramer acetate $311,927 11.272 Ref Ref (Copaxone) Interferon beta-1b $323,995 11.376 $115,694 $115,694 (Extavia) Dimethyl fumarate $353,243 11.442 $243,695 $448,383 (Tecfidera) Natalizumab (Tysabri) $475,615 11.580 $531,700 $884,714 Dominated treatments Dominated by interferon Interferon beta-1b $337,364 11.395 $243,863 beta-1b 250 mcg (Betaseron) (Extavia) Dominated by interferon Interferon beta-1a 22 beta-1b 250 mcg $340,051 11.190 Dominated mcg (Rebif) (Extavia) and glatiramer acetate

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Table 46: Univariate Sensitivity Analysis Regarding Cost of Relapse Cost per relapse = $1,405 Grima et al.74 ICUR versus Treatment Total Cost Total QALYs glatiramer Sequential ICUR acetate Dominated by interferon Interferon beta-1a beta-1b 250 mcg $346,446 11.168 Dominated (Avonex) (Extavia) and glatiramer acetate Dominated by interferon beta-1b 250 mcg Interferon beta-1a 44 $368,068 11.271 Dominated (Extavia), glatiramer mcg (Rebif) acetate and dimethyl fumarate Dominated by dimethyl Fingolimod (Gilenya) $408,527 11.422 $644,451 fumarate Increase cost of relapse by 100% Cost of moderate relapse = $12,804 Cost of severe relapse = $30,730 Glatiramer acetate $361,258 11.272 Ref Ref (Copaxone) Interferon beta-1b $374,683 11.376 $128,702 $128,702 (Extavia) Dimethyl fumarate $396,362 11.442 $207,052 $332,343 (Tecfidera) Natalizumab (Tysabri) $510,441 11.580 $484,584 $824,762 Dominated treatments Dominated by interferon Interferon beta-1b $388,052 11.376 $256,871 beta-1b 250 mcg (Betaseron) (Extavia) Dominated by interferon Interferon beta-1a 22 beta-1b 250 mcg $390,526 11.187 dominated mcg (Rebif) (Extavia) and glatiramer acetate Dominated by interferon Interferon beta-1a beta-1b 250 mcg $403,693 11.167 dominated (Avonex) (Extavia) and glatiramer acetate Dominated by interferon beta-1b 250 mcg Interferon beta-1a 44 $417,550 11.262 dominated (Extavia), glatiramer mcg (Rebif) acetate and dimethyl fumarate Dominated by dimethyl Fingolimod (Gilenya) $448,795 11.422 $583,987 fumarate

ICUR = incremental cost-utility ratio; mcg = microgram; mg = milligram; QALY = quality-adjusted life-year

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