Качественная клиническая практика (May 2018)
Pharmacoeconomic analysis of the use of botulinum toxin in the treatment of poststroke spasticity
Abstract
We conducted a comparative pharmacoeconomic analysis of the use of botulin toxin drugs in complex therapy of poststroke spasticity syndrome under Russian conditions. Together with a health economic modelling, we conducted a “standard practice” analysis through polling of experts (neurologist physicians) with subsequent use of the Delphi method. We evaluated three medical technologies for treatment of poststroke spasticity in combination with standard clinical practice: treatment using drug-induced local miorelaxation by Botox®, Dysport® and Xeomin®. In the modelling, we used a Markov cycle, a probabilistic sensitivity analysis and budget impact analysis. It was determined that, in conducting one course of therapy, the strategy using Botox® was least expensive and most effective, both in the case of examining one course of therapy and according to the results of three-year observation. According to the results of the cost-effectiveness analysis for therapy of the various strategies, the strategy using Botox® was predominant. That result was observed both when examining efficacy and when examining effectiveness according to the results of the three-year modelling of using the treatment strategies. From the standpoint of the budget impact analysis, Botox® is also the most preferable strategy: using this drug saves up to 141 million rubles of budgetary funds and makes it possible to treat an additional 227 patients with this strategy. The results obtained in the mathematical modelling correlate to the “standard” data of clinical practice and the pharmacoepidemiological analysis conducted concurrently.
