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Abstract
Background
Cervical dystonia (CD) can be effectively managed by a combination of botulinum neurotoxin A (BoNT-A) and conventional therapy (skeletal muscle relaxants and rehabilitative therapy), but the costs of different interventions in the UK vary.
Methods
A budget impact model was developed from the UK payer perspective with a 5-year time horizon to evaluate the effects of changing market shares of abobotulinumtoxinA, onabotulinumtoxinA, and incobotulinumtoxinA, and best supportive care from the UK payer perspective. Epidemiological and resource use data were retrieved from the published literature and clinical expert opinion. Deterministic sensitivity analyses were performed to determine the parameters most influential on the budgetary findings under base case assumptions.
Results
Under base case assumptions, an increased uptake of abobotulinumtoxinA showed an accumulated savings of £2,250,992 by year 5. Treatment per patient per year with onabotulinumtoxinA and incobotulinumtoxinA costs more when compared to treatment with abobotulinumtoxinA. One-way sensitivity analyses showed that the prevalence of CD, dose per injection of each of the BoNT-As, and time to reinjection of incobotulinumtoxinA and abobotulinumtoxinA influenced the base case findings most.
Conclusion
There is potential for cost savings associated with the greater use of abobotulinumtoxinA rather than other BoNT-A treatments, permitting more patients to benefit more from effective BoNT-A treatment with a fixed budget.
Acknowledgments
This study was funded by Ipsen Pharma. The abstract of this paper was presented at the 18th International Congress of Par-kinson’s Disease and Movement Disorders, 2014, as a poster presentation with interim findings. The poster’s abstract was published in the “Poster Abstracts” in Movement Disorders Volume 29, June 2014 Abstract Supplement: http://www.mdsabstracts.com/abstract.asp?MeetingID=801&id=112338. The actual paper, however, has never been published. No additional data are available.
Author contributions
KD, JD, and SG reviewed all stages of the work, including model development, evaluation of selected data sources, and critical review of the results. TH reviewed the final model structure, data sources and results, and provided expert opinion for the model inputs that were unavailable from published sources. SB and SA gathered the data necessary for the model and performed model analyses. Additionally, SB performed the model programming, and SA wrote the manuscript. All authors critically reviewed the final version of the manuscript for its content and accuracy and agree that the conclusions presented are appropriately balanced. All authors contributed toward data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.
Disclosure
SA, SB, and KD are employees of Evidera Inc., which received consultancy fees to conduct the research from Ipsen Pharma. JD and SG are both full-time employees of Ipsen Pharma. TH has received consultancy fees from Ipsen Pharma. Ipsen Pharma did not have any influence on the interpretation of the data, as well as on the final conclusions drawn. The authors report no other conflicts of interest in this work.