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Article History

Received: 26 February 2025

Accepted: 31 August 2025

First Online: 18 September 2025

Declarations

:

: R Bergamaschi has received honoraria for speaking from Biogen, Merck Serono, Roche, Novartis, Celgene, Janssen, and Sanofi Genzyme; research grants from Biogen, Merck Serono, Roche, Novartis, and Sanofi Genzyme; and congress and travel/accommodation expenses from Biogen, Merck Serono, Roche, Novartis, and Sanofi Genzyme. V Brescia Morra has received research grants from the Italian MS Society and Roche and honoraria from Bayer, Biogen, Merck, Mylan, Novartis, Roche, Sanofi-Genzyme, and Teva. L Prosperini has received consulting fees from Biogen, Merck, Novartis, and Roche; speaker honoraria from Biogen, Genzyme, Merck, Serono, Novartis, Roche, and Teva; travel grants from Biogen, Genzyme, Novartis, Roche, and Teva; and research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme. PA Cortesi has received speaker honoraria from Novartis and Roche. C Fornari has no conflicts of interest. D Perini and L Santoni are employees of and may hold stock in Biogen.

: Ethical approval is not required for simulation-based studies in the present study’s jurisdiction.

: Not applicable.

: Not applicable.

: Model input data are available within the paper, and simulation models are available upon request.

: All authors contributed to the development of the economic model and approved its final version. All the authors revised and approved the conducted analyses and results. All authors are responsible for the revision of the manuscript. All authors read and approved the final version of the manuscript.