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Retigabine as add‐on treatment of refractory epilepsy – a cost‐utility study in a Swedish setting
Author(s) -
Kristian B.,
Wachtmeister K.,
Stefan F.,
Forsgren L.
Publication year - 2013
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12077
Subject(s) - refractory (planetary science) , epilepsy , medicine , intensive care medicine , psychiatry , astrobiology , physics
Objectives To calculate comparative incremental cost‐effectiveness ratios (cost per quality‐adjusted life year, QALY ) and net marginal benefits for retigabine as add‐on treatment for patients with uncontrolled focal seizures as compared to add‐on lacosamide treatment and no add‐on treatment, respectively. Materials & Methods Calculations were performed using a validated decision‐tree model. The study population consisted of adult patients with focal‐onset epilepsy in published randomized placebo‐controlled add‐on trials of retigabine or lacosamide. Healthcare utilization and QALY for each treatment alternative were calculated. Probabilistic sensitivity analysis was performed using the specification of this model as a basis for M onte C arlo simulations. 2009 prices were used for all costs. Results Results were reported for a 2‐year follow‐up period. Retigabine add‐on treatment was both more effective and less costly than lacosamide add‐on treatment, and the cost per additional QALY for the retigabine no add‐on (standard) therapy comparison was estimated at 2009€ 15,753. Using a willingness‐to‐pay threshold for a QALY of € 50,000, the net marginal values were estimated at 2009€ 605,874 for retigabine vs lacosamide and 2009€ 2,114,203 for retigabine vs no add‐on, per 1,000 patients. The probabilistic analyses showed that the likelihood that retigabine treatment is cost‐effective is at least 70%. Conclusions The estimated cost per additional QALY , for the retigabine vs no add‐on treatment comparison, is well within the range of newly published estimates of willingness to pay for an additional QALY . Thus, add‐on retigabine treatment for people with focal‐onset epilepsy with no/limited response to standard antiepileptic treatment appears to be cost‐effective.