The impact of monoclonal antibody drugs on healthcare economics in the treatment of multiple sclerosis and neuromyelitis optica spectrum disorders

The launch of highly efficacious monoclonal antibody (mAb) drugs has profoundly changed the therapeutic strategy for multiple sclerosis and neuromyelitis optica spectrum disorders (NMOSD). However, the newly developed mAb drugs, especially those used in treating NMOSD, are quite expensive, resulting in a significant medical and economic burden. Early use of these drugs is expected to reduce the frequency of relapse and the accumulation of disability, preserve the quality of life of patients, and improve their life expectancy. In selecting therapeutic drugs, it is necessary not only to consider the efficacy and safety of the drugs, but also to consider the cost-effectiveness of each drug for each patient, considering the economic aspects of health care. However, the cost-effectiveness of mAb drugs in treating multiple sclerosis and NMOSD has not been fully verified. Japan is rapidly emerging as a hyper-aged society, unlike any other in the world, and the rising cost of medical care is an urgent issue that needs to be addressed and resolved. Out-of-pocket expenses of individual patients are not a major issue in Japan as medical, costs for multiple sclerosis and NMOSD are subsidized by public medical insurance; however, the judicious use of mAb drugs is required to ensure cost-effectiveness.