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Regional disparities in botulinum toxin A (Bo NT ‐A) therapy for spasticity in Sweden: budgetary consequences of closing the estimated treatment gap
Author(s) -
Ertzgaard P.,
Anhammer M.,
Forsmark A.
Publication year - 2017
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.12610
Subject(s) - closing (real estate) , spasticity , botulinum toxin , medicine , physical medicine and rehabilitation , physical therapy , business , surgery , finance
Objectives As no national treatment guidelines for spasticity have been issued in Sweden, different regional treatment practices may potentially occur. This study examines botulinum toxin A (Bo NT ‐A) treatment for spasticity on a regional level in Sweden and presents budgetary consequences of closing the estimated treatment gap. Materials and Methods Prevalence of spasticity in Sweden was estimated from published data. Regional sales data for Bo NT ‐A were acquired from IMS Health. A set proportion of hospital Bo NT ‐A use was assumed to represent treatment of spasticity. Total intervention cost of Bo NT ‐A treatment was gathered from healthcare regional tariffs, while costs associated with spasticity were derived from publications on multiple sclerosis and stroke. Results Results show that the regional variation in treatment of spasticity with Bo NT ‐A is large, with approximately every fourth patient being treated in Southern healthcare region compared to every tenth in the Stockholm–Gotland or Western healthcare regions. The incremental cost of filling the reported treatment gap was also assessed and was estimated at around 9.4 million EUR . However, for the incremental cost to be offset by savings in spasticity‐related costs, only a small proportion of treatment responders (defined as patients transitioning to a lower severity grade of spasticity) was required (12%). Conclusions The study revealed apparent regional disparities of Bo NT ‐A treatment for spasticity in Sweden. The results further suggest that the incremental cost of eliminating the treatment gap has a high probability of being offset by savings in direct costs, even at a low proportion of the patients reaching clinical improvement.