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

ABSTRACT

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.

KEYWORDS:

• Cost utility
• anti-epileptic drugs
• adjunctive therapy
• markov model
• monte Carlo simulation

Acknowledgments

We would also like to thank John Wright for the English editing.

Authors’ contributions

Isabel Barrachina conceived of the study, its design, performed part of the literature review and coordinate the draft the manuscript; David Vivas participated in the design of the study, performed part of the literature review and helped to draft the manuscript; Francisco Reyes-Santias performed part of the literature review and helped to draft the manuscript.

Availability of data and supporting materials section

No additional data are available.

Consent for publication

Not applicable.

Ethics approval and consent to participate

Not applicable.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.