• Am J Health Syst Pharm · Feb 2015

    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. rashidkazerooni@hotmail.com.
    • Am J Health Syst Pharm. 2015 Feb 15; 72 (4): 301-7.

    PurposeA cost-utility analysis of botulinum toxin type A products for the treatment of cervical dystonia (CD) was conducted.MethodsA 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.ResultsAll 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%).ConclusionA 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.Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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