Lifetime Cost-Utility Analysis of Patients with Refractory Epilepsy Treated with Adjunctive Topiramate Therapy

Abstract

Our results showed that adjunctive topiramate therapy has a favourable pharmacoeconomic profile in patients with refractory epilepsy.

A systematic review of economic evaluations of treatments for patients with epilepsy

“…Three studies were identified that looked at the costeffectiveness of epilepsy surgery and compared it with 35 20 2 5 90.9 Beretta et al 47 15 5 7 75.0 Blais et al 36 19 2 6 90.5 Bolin et al 23 17 5 4 77.3 Bowen et al 40 22 1 4 95.7 Chisholm et al 20 16 7 4 69.6 Chisholm et al 21 14 9 4 60.9 Clements et al 39 19 4 4 82.6 Craig et al 32 12 11 4 52.2 De Kinderen et al 44 21 2 3 91.3 De Kinderen et al 43 19 1 7 95.0 Frew et al 33 16 6 5 72.7 Gharibnaseri et al 34 16 5 6 76.2 Gureje et al 22 5 17 5 22.7 Hawkins et al 29 22 0 4 100.0 Helmers et al 45 16 5 6 76.2 Jentink et al 66 31 18 5 4 78.3 Lee et al 51 22 1 4 95.7 Lee et al 52 19 3 5 86.4 Majoie et al 46 11 8 8 57.9 Maltoni and Messori 27 18 5 4 78.3 Marson et al 17 21 1 5 95.5 Noble et al 48 19 1 7 95.0 Oldham et al 42 9 11 7 45.0 Plumpton et al 49 16 6 5 72.7 Rane et al 50 4 16 7 20.0 Remak et al 16 18 5 4 78.3 Remak et al 28 16 5 6 76.2 Simoens et al 24 23 0 4 100.0 Spackman et al 30 20 3 4 87.0 Suh and Lee 37 18 4 5 81.8 Van Hout et al 15 11 11 5 50.0 Vera-Llonch et al 26 18 5 4 78.3 Verdian et al 38 23 0 4 100.0 Widjaja et al 41 18 4 5 81.8 Average quality score: 77.0 "Yes" indicates sufficiently/correctly described and conducted in the study; "No" indicates insufficient, wrong, or no information regarding the specific topic in the study; NA, not applicable. A full description of the items can be found in Appendix S2.…”

Cost Effectiveness of Lacosamide in the Adjunctive Treatment of Patients with Refractory Focal Epilepsy in Belgium

“…Thus, we conducted a systematic review of the literature and identified five publications reporting utility values for people living with epilepsy. [7][8][9][10][11] Utility values were derived from an Italian study by Messori et al, [10] as the authors used a validated method to derive utility values and the uti- Table I. a Weighted average from Messori et al [10] b The model did not consider being seizure free because the study population consisted of patients who had uncontrolled epilepsy despite previous treatment with at least two other AEDs and because the trial probabilities of being seizure free with lacosamide were small.…”

“…Utilities were assumed to have b distributions, with ranges based on literature values. [7][8][9][10][11] For each of the 1000 iterations, the simulation drew input parameters at random from their statistical distributions and calculated cost and effectiveness pairs. At the end of the 1000 iterations, the joint statistical distribution for costs and effectiveness was represented as a cloud of points on the cost-effectiveness plane.…”

“…[5] QoL associated with epileptic seizures is impaired as indicated by utility values ranging from 0.66 to 0.91 (on a scale of 0-1) in epileptic patients who do not achieve seizure freedom. [7][8][9][10][11] A bottom-up, prevalencebased, cost-of-illness study estimated the costs of epilepsy from a societal perspective in the 27 EU member countries, plus Iceland, Norway and Switzerland. [6] The estimated total cost of the disease in Europe was h13.8 billion in 2010, consisting of h6.5 billion of direct healthcare costs, h5.6 billion of indirect costs and h1.7 billion of direct non-medical costs.…”

Assessment of components included in published societal perspective or QALY outcome economic analyses for antiepileptic drug treatment in chronic epilepsy

“…Two lifetime horizon societal studies specifically excluded indirect costs (e.g. productivity) and nonmedical costs [44,45].…”