Cost-utility analysis of botulinum toxin type A products for the treatment of cervical dystonia [Notes]

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Cost-utility analysis of botulinum toxin type A products for the treatment of cervical dystonia Rashid Kazerooni? and Christine Broadhead

Rashid Kazerooni, Pharm.D., BCPS, is Pharmacoeconomics Program Manager, Veterans Affairs San Diego Healthcare System, San Diego, CA. Christine Broadhead, B.S.N., RN, is Critical Care Nurse, Sharp HealthCare, San Diego. Address correspondence to Dr. Kazerooni (rashidkazerooni{at}hotmail.com). Abstract Purpose A cost-utility analysis of botulinum toxin type A products for the treatment of cervical dystonia (CD) was conducted.

Methods A cost-utility analysis of botulinum toxin type A products was conducted from the U.S. government perspective using a decision-analysis model with a one-year time horizon. Probabilities of the model were taken from several studies using the three botulinum type A products approved by the Food and Drug Administration for the treatment of CD: onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport), and incobotulinumtoxinA (Xeomin). The main outcome measurement was successful treatment response with botulinum toxin type A, measured in quality-adjusted life years (QALYs). Response was defined as a patient who experienced improvement of CD symptoms without a severe adverse event. Probabilistic sensitivity analysis was conducted to test robustness of the base-case results.

Results All three botulinum toxin type A agents were cost-effective at a willingness-to-pay threshold of $100,000 per QALY. Xeomin was the most cost-effective with a cost-effectiveness ratio of $27,548 per QALY. Xeomin was dominant over the alternative agents with equivalent efficacy outcomes and lower costs. Dysport had the second lowest cost-effectiveness ratio ($36,678), followed by Botox ($49,337). The probabilistic sensitivity analysis supported the results of the base-case analysis. Dysport was associated with the lowest wastage (2.2%), followed by Xeomin (10%) and Botox (22.9%).

Conclusion A cost-utility analysis found that Xeomin was the more cost-effective botulinum toxin type A product compared with Botox and Dysport for the treatment of CD. Wastage associated with the respective products may have a large effect on the cost-effectiveness of the agents.

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? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140276 American Journal of Health-System Pharmacy February 15, 2015 vol. 72 no. 4 301-307 ? Abstract Full Text Full Text (PDF) Classifications Print Content Notes Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Kazerooni, R. Articles by Broadhead, C. PubMed PubMed citation Articles by Kazerooni, R. Articles by Broadhead, C. Related Content Load related web page information Social Bookmarking CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

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