Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain

Martínez, Isabel Barrachina; Vivas-Consuelo, David; Piera-Balbastre, Anna

doi:10.1007/s40261-017-0615-z

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Withdrawn or discontinuation is usually due to problems of intolerance to treatment. This justifies that p 14 = p 24 = p 34 have been taken in model ( 1), for more information on the topic see references [10,15]. In a Markov chain, we can determine the state x n from an initial condition x 0 and the transition matrix p. For the sake of simplicity, in the following, we take as initial condition x 0 = (1, 0, 0, 0) , that is, all population starts being no response to treatment.…”

Section: Motivation and Preliminariesmentioning

confidence: 76%

“…The probabilities of transition between health states have been obtained from a Network meta-analysis, which is a methodology that synthesise networks of direct and indirect comparisons of interventions, and facilitate researchers to simultaneously check the effects of more than two interventions for the same condition [21]. These probabilities are calculated for one year of treatment, the following matrix for the Brivaracetam AED is obtained [15] Then, for Brivaracetam AED p 12 = 0.02520, p 13 = 0.13765 and p 14 = 0.0572. Now, we assume that P 12 , P 13 and P 14 are independent absolutely continuous RVs.…”

Section: -Pdf Of the Solution Spmentioning

confidence: 99%

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Probabilistic Study of the Effect of Anti-Epileptic Drugs Under Uncertainty: Cost-Effectiveness Analysis

et al. 2020

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Epilepsy is one of the most ancient diseases. Despite the efforts of scientists and doctors to improve the quality of live of epileptic patients, the disease is still a mystery in many senses. Anti-epileptic drugs are fundamental to reduce epileptic seizures but it have some adverse effects, which influence the quality of life outcomes of the patients. In this paper, we study the effectiveness of anti-epileptic drugs taking into account the inherent uncertainty. We establish a model, which allows to represent the natural history of epilepsy, using Markov chains. After randomizing the mathematical model, we compute the first probability density function of the solution stochastic process applying the random variable transformation technique. We also take advantage of this method to determine the distribution of some key quantities in medical decision, such as the time until a certain proportion of the population remains in each state and the incremental cost-effectiveness ratio. The study is completed computing all these quantities using data available in the literature. In addition, regarding the incremental cost-effectiveness ratio, different third generation anti-epileptic treatments are compared with the Brivaracetam, a new third generation anti-epileptic drug.

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Section: Motivation and Preliminariesmentioning

confidence: 76%

Section: -Pdf Of the Solution Spmentioning

confidence: 99%

Probabilistic Study of the Effect of Anti-Epileptic Drugs Under Uncertainty: Cost-Effectiveness Analysis

et al. 2020

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“…The budgetary impact study for the introduction of BRV into the portfolio of anti-epileptic drugs for patients over 16 with POS (Barrachina et al) (2018) shows savings of 0.23% of the cost of adjunctive treatments for epilepsy over five years. A probabilistic sensitivity analysis performed through a Monte Carlo simulation where all the variables introduced into the budget impact analysis varied simultaneously estimated that the probability of savings for the National Health Service was 84% [21].…”

Section: Discussionmentioning

confidence: 99%

Cost-utility model of brivaracetam in the adjunctive treatment of patients with epilepsy in Spain

Martínez

Vivas-Consuelo

Reyes-Santías

2020

Expert Review of Pharmacoeconomics & Outcomes Research

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Objective: This study aims to assess the cost utility of Brivaracetam compared with the third-generation anti-epileptic drugs used as standard care. Methods: A cost utility analysis of Brivaracetam was carried out with other third-generation comparators. The treatment pathway of a hypothetical cohort over a period of 2 years was simulated using the Markov model. Data for effectiveness and the QALYs of each health status for epilepsy, as well as for the disutilities of adverse events of treatments, were analyzed through a studies review. The cost of the anti-epileptics and the use of medical resources linked to the different health statuses were taken into consideration. A probabilistic sensitivity analysis was performed using a Monte Carlo simulation. Results: Brivaracetam was shown to be the dominant alternative, with Incremental Cost Utility Ratio (ICUR) values from −11,318 for Lacosamide to −128,482 for Zonisamide. The probabilistic sensitivity analysis validates these results. The ICUR sensitivity is greater for increases in the price of Brivaracetam than for decreases, and for Eslicarbizapine over the other adjunctives considered in the analysis. Conclusions: Treatment with Brivaracetam resulted in cost effective and incremental quality adjusted life years come at an acceptable cost.

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“…This study simulated the cost-effectiveness of using adjunctive brivaracetam compared with perampanel in the treatment of focal onset seizures in Finland. Recently, cost savings on use of brivaracetam were demonstrated in Spain [68], in contrast to the neutral budget impact for the use of perampanel in the USA [69]; in both instances brivaracetam was compared with the current treatment practice. Here, we extended the setting to analysis of the economic value, i.e., evaluation of the modeled costs, effectiveness, and full cost-utility analysis also including NMB-comparing these two recently approved AEDs for treatment of focal onset seizures and including quality-adjusted survival measured as both QALYs and payers' direct costs.…”

Section: Discussionmentioning

confidence: 99%

Economic Value of Adjunctive Brivaracetam Treatment Strategy for Focal Onset Seizures in Finland

et al. 2019

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Introduction: There is an unmet need for welltolerated antiepileptic drugs (AEDs) that effectively control focal onset seizures. This study aimed to evaluate the economic value of new AEDs in the treatment of focal onset seizure, with or without secondary generalization, in Finnish adults and adolescents with epilepsy, comparing brivaracetam with perampanel as adjunctive AEDs. Methods: Economic value was assessed using cost-utility analysis. Periods of AED initiation, titration, response assessment (seizure freedom, C 50% reduction, no response), switching in no response or treatment-emergent adverse events (TEAEs), and death were simulated using a discrete-event simulation model. Responses and switching were simulated based on a comprehensive Bayesian network meta-analysis. The primary modeled outcome was the 3%/year discounted incremental cost-effectiveness ratio (ICER). Discounted quality-adjusted life-years (QALYs), payer costs (year 2017 Euro) per patient, and net monetary benefit (NMB) were secondary outcomes. Probabilistic and comprehensive deterministic sensitivity analyses were conducted. Results: Brivaracetam was more efficacious and had fewer TEAEs than perampanel and other AEDs. Modeled average 5-year QALYs and costs were 3.671 and €28,297 for brivaracetam and 3.611 and €27,979 for perampanel, respectively. The resulting ICER for brivaracetam versus Enhanced Digital Features To view enhanced digital features for this article go to

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Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain

Cited by 5 publications

References 19 publications

Probabilistic Study of the Effect of Anti-Epileptic Drugs Under Uncertainty: Cost-Effectiveness Analysis

Probabilistic Study of the Effect of Anti-Epileptic Drugs Under Uncertainty: Cost-Effectiveness Analysis

Cost-utility model of brivaracetam in the adjunctive treatment of patients with epilepsy in Spain

Economic Value of Adjunctive Brivaracetam Treatment Strategy for Focal Onset Seizures in Finland

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