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This study aimed to evaluate the cost-effectiveness of three natalizumab treatment strategies during pregnancy from the UK healthcare system\u2019s perspective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Continuing natalizumab throughout pregnancy was the most cost-effective strategy, yielding the highest incremental QALY gains and the lowest incremental cost per QALY (\u00a31713 per QALY), with a net monetary benefit of \u00a3743. 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00415-024-12736-z","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T11:12:45Z","timestamp":1736248365000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost effectiveness of different treatment strategies with natalizumab for pregnant women with multiple sclerosis"],"prefix":"10.1007","volume":"272","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2179-9224","authenticated-orcid":false,"given":"Magdalena","family":"Walbaum","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anushka","family":"Madhukar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Dobson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Cyhlarova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Castro-Aldrete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Santuccione Chadha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Knapp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"issue":"7","key":"12736_CR1","doi-asserted-by":"publisher","first-page":"3696","DOI":"10.3390\/ijms22073696","volume":"22","author":"B Angeloni","year":"2021","unstructured":"Angeloni B, Bigi R, Bellucci G et al (2021) A case of double standard: sex differences in multiple sclerosis risk factors. 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She served on advisory boards for Roche, Biogen, Janssen and Merck and study steering committees for Roche. All honoraria are paid into an institutional account and used to support research and training. She has received grant support from Biogen, Merck, Celgene. ASC is founder of the Women's Brain Foundation and Vice President at Euresearch. All other authors declare that there are no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study did not require ethical approval as the work used only publicly available, published data. No new data involving human participants or animals were collected for this study. All data sources utilised are freely available in the public domain and are fully cited in the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standard statement"}}],"article-number":"93"}}