Sativex® in multiple sclerosis spasticity: a cost–effectiveness model

Abstract

Background: Multiple sclerosis (MS) is a chronic, progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and a key contributor to MS-related disability. Objectives: This study evaluated the cost–effectiveness of Sativex®, a 9-d-tetrahydrocannabinol/cannabidiol-based oromucosal spray that acts as an endocannabinoid system modulator. Sativex was recently approved for the management of resistant MS spasticity as add-on medication. Methods: A Markov model-based analysis was performed over a 5-year horizon from a German and Spanish healthcare payer perspective. The incremental cost of Sativex was low compared with current spasticity treatments, and provided a quality-adjusted life-year gain over the current standard of care. Results: The base-case incremental cost–effectiveness ratio for Sativex was estimated at €11,214/quality-adjusted life-year in Germany, while the drug was the dominant option in Spain, providing savings of €3496/patient over a 5-year period (year of costing: 2010). This was seen because the lower severity of spasticity in patients who had improved led to reduced resource consumption (e.g., physiotherapy and medications). Conclusion: Despite having a relatively high acquisition cost, Sativex was shown to be a cost–effective treatment option for patients with MS-related spasticity.

Keywords::

• cost–effectiveness
• Delphi survey
• healthcare costs
• Markov model
• multiple sclerosis
• pharmacoeconomic analysis
• Sativex®
• spasticity

Financial & competing interests disclosure

SA Almirall commissioned A Gras of GfK Bridgehead for the development of the models and the preparation of this article. GfK Bridgehead has also worked for GW Pharmaceuticals, Sativex marketing authorization holder in EU. J Slof received an honorarium from Laboratorios SA Almirall for reviewing the models and preparing this article. The authors have no other 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 apart from those disclosed.

Editorial assistance for this article was kindly provided by Content Ed Net, Madrid, Spain. Funding for editorial assistance was provided by Almirall, Barcelona, Spain.