Качественная клиническая практика (May 2018)
Clinical-economic analysis of valproate microsphere form in focal epilepsy in adults (real world evidences)
Abstract
Clinical and economical results of switching from original valproate - Depakine Chronosphere - to generic tablets of prolong action in adult patients with focal epilepsy has been performed. Methodology: In 127 patients duration of Depakine Chronosphere usage before switching, it’s dosage, efficacy, drug of switching, it’s dosage, dynamic of epilepsy seizures during half of the year after were fixed. Also were calculated total amount of out-patients visits, emergency calls, admission to hospitals, disability days before and after switching. Direct costs, including pharmacotherapy, hospitalization, out-patients visits etc., have been summarized. And total expenditures for one patient were calculated with cost-effective ratio during half of the year before and after switching were ensured. Results: Adult patients with focal epilepsy (127 pts) have been switched by doctors for technical, non medical, reasons to receive valproate Gxs instead previous treatment with Depakine Chronosphere. Patients have switched to Convulex (n=79.), Encorat (n= 27), Valparin ХР (n=21). After Convulex switching the total amount of patients in remission is less than in Depakine treatment. Absolute Risk of seizures is increased on 16,5%, relative risk - on 27,7%. Total amount of out-patients’ visits increased on 47,2% by the less Convulex efficacy as well as necessity in hospitalization has been occurred, and disability days count was 3,35 in average after switching. Total expenditures after switching from Depakine Chronosphere to Convulex were increased, and cost-effective ration for Depakine Chronosphere was less on 80,4% in compare with Convulex. In other cases of switching from original to Gxs valproate results were similar - efficacy was less and cost was increased. Conclusion: Switch from Depakine Chronosphere to valproate Gxs in focal epilepsy in adults is not justified from clinical point of view and more expensive from economic point of view.
