Economic Value of Adjunctive Brivaracetam Treatment Strategy for Focal Onset Seizures in Finland
| العنوان: | Economic Value of Adjunctive Brivaracetam Treatment Strategy for Focal Onset Seizures in Finland |
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| المؤلفون: | Reetta Kälviäinen, Mata Charokopou, Jukka Peltola, M. Taiha, Saku Väätäinen, Erkki Soini |
| المساهمون: | Lääketieteen ja terveysteknologian tiedekunta - Faculty of Medicine and Health Technology, Tampere University |
| المصدر: | Advances in Therapy |
| بيانات النشر: | Springer Healthcare, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, 030213 general clinical medicine, Pediatrics, medicine.medical_specialty, Adolescent, Focal onset seizure, Cost-Benefit Analysis, Brivaracetam, PICOSTEPS, Perampanel, Unmet needs, 03 medical and health sciences, Epilepsy, chemistry.chemical_compound, 0302 clinical medicine, Seizures, Neurologia ja psykiatria - Neurology and psychiatry, medicine, Humans, Pharmacology (medical), Adverse effect, health care economics and organizations, Finland, Original Research, business.industry, Bayes Theorem, General Medicine, medicine.disease, Base case scenario, Economic evaluation, Pyrrolidinones, Response assessment, Treatment Outcome, chemistry, 030220 oncology & carcinogenesis, Treatment strategy, Anticonvulsants, Drug Therapy, Combination, Female, Quality-Adjusted Life Years, business, Farmasia - Pharmacy, medicine.drug |
| الوصف: | Introduction There is an unmet need for well-tolerated 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, ≥ 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 perampanel was only €5345/QALY gained in a deterministic base case scenario. Brivaracetam had a positive NMB and high probability of cost-effectiveness of €1190 and 71% or €1944 and 80% with the assumed willingness to pay of €25,358 or €38,036/QALY gained, respectively. The primary result was robust, with a positive NMB persistent in all sensitivity analysis scenarios. When switching from brivaracetam to perampanel was excluded from the modeling or switching from perampanel to brivaracetam was included, brivaracetam was cost-saving and more effective than perampanel (dominant). Conclusion These simulated comparisons demonstrated that brivaracetam was more effective and potentially also more affordable than perampanel. Thus, brivaracetam is likely a cost-effective and net beneficial alternative to perampanel for treatment of focal onset seizures. Plain Language Summary Plain language summary available for this article. Electronic supplementary material The online version of this article (10.1007/s12325-019-01155-6) contains supplementary material, which is available to authorized users. |
| وصف الملف: | fulltext; 477–500 |
| اللغة: | English |
| تدمد: | 1865-8652 0741-238X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f1dd2f438d1e9d0fd8f94e9b129f8df4 http://europepmc.org/articles/PMC6979440 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f1dd2f438d1e9d0fd8f94e9b129f8df4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18658652 0741238X |
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