Cost-Effectiveness of Teriflunomide and Fingolimod in The First-Line Treatment of Relapsing-Remitting Multiple sclerosis：The Chinese Health System Perspective

Abstract Objective The aim of this study is to evaluate the cost-effectiveness of teriflunomide and fingolimod in relapsing-remitting patients in the first-line treatment from the perspective of the Chinese health system perspective.Methods A Markov model was developed to evaluate the cost effectiveness of disease-modifying drugs (DMDs) from the Chinese health system perspective.Cost input includes medication, follow-up, nursing, recurrence treatment and adverse reaction management.Treatment effects, including monthly confrmed disability worsening and annualized relapse rate.The output result was ICER and the threshold of willingness to pay(WTP) was three times per capita GDP.One-way sensitivity analysis and probability sensitivity analysis are carried out to test the stability of the model results.Results In the context of medical insurance with Chinese characteristics.The total cost of treatment with teriflunomide was ¥423,816.61, and the total cost of treatment with fingolimod was ¥656,055.95.The cumulative QALYs of teriflunomide was 5.14, and the cumulative QALYs of fingolimod was 5.25.The ICER value of Fingolimod and Liflunomide is ¥2139444.61/QALY, which is higher than WTP , so teriflunomide has a dominant advantage.Sensitivity analysis proves that the model was stable.Conclusion From the perspective of Chinese health system perspective, teriflunomide is the more cost-effective of the two interventions.