Cost-effectiveness of perampanel for the treatment of primary generalized tonic-clonic seizures (PGTCS) in epilepsy: A Spanish perspective

Tremblay, Gabriel; Howard, Daniel; Tsong, Wan; Patel, Vardhaman; Rosendo, Jesús De

doi:10.1016/j.yebeh.2018.06.002

Cited by 11 publications

(13 citation statements)

References 19 publications

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“…Currently, there are limited documents on the economic evaluation of PER. An economic evaluation based on the perspective of Spain showed that the ICER of PER as an adjuvant therapy to AEDs was €16,557/QALY over a 33-year study period; with the willingness-to-pay of €30,000/QALY, PER had an 89.3% probability of being the cost-effective option for primary generalized tonic-clonic epileptic seizures ( 18 ). Here, our study from the perspective of China's health system shows that using PER as an adjuvant therapy to AEDs has an dominate advantage over LCM in terms of CE.…”

Section: Discussionmentioning

confidence: 99%

“…However, we found this assumption was uncertain compared with other studies. Considering that the transition patterns of response rates are the basis of the cycle in the model, we designed a scenario analysis according to the pharmacoeconomic study of Tremblay et al (18): assuming that there are probabilities for patients with a response rate of <50% transitioning to the state of increased seizures, and the transition is expressed by the following equation: P < 50% to increase in seizures = P increase in seizures * (1 -P responsive).…”

Section: Uncertainty Analysismentioning

confidence: 99%

“…Bolin et al showed that LCM was cost-effective as an add-on therapy for uncontrolled partialonset seizures (21). In 2018, the economic efficiency of PER as an add-on therapy for primary systemic tonic-clonic seizures was confirmed in Spain (18). However, the economic efficiency of PER therapy for partial-onset seizures in China remains unknown, and there is a lack of comparison between PER and LCM.…”

Section: Introductionmentioning

confidence: 99%

“…In the 2018 guidelines from the American Academy of Neurology and the American Epilepsy Association (AAN/AES), the grades of evidence-based recommendation for PER and LCM are A and B, respectively ( 11 ). Cost-effectiveness (CE) evidence and budget impact analysis (BIA) of PER have been reported in other countries ( 18 , 19 ). Some studies have also explored the CE of LCM as an add-on to conventional AED therapy ( 20 , 21 ).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have also explored the CE of LCM as an add-on to conventional AED therapy ( 20 , 21 ). All these studies have demonstrated that PER or LCM as an add-on therapy for uncontrolled or refractory epilepsy is a cost-effective regimen ( 18 , 20 , 21 ).…”

Section: Introductionmentioning

confidence: 99%

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Value of Perampanel as Adjunctive Treatment for Partial-Onset Seizures in Epilepsy: Cost-Effectiveness and Budget Impact Analysis

Zhang

Ding

et al. 2021

Front. Public Health

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Introduction: China has ~6 million patients with active epilepsy every year, around 60% of whom suffer from partial-onset seizures. Perampanel (PER) is a novel anti-epileptic drug for partial-onset seizures. PER has been included in the latest Chinese National Reimbursement Drug List (NRDL) in 2020. However, there is still a lack of evaluation evidence on the value of PER in China.Methods: This study selected a health system perspective. A Markov model was established to simulate the lifelong transition of different response levels and calculate the number of seizures in Chinese patients. Based on the utility value and mortality risk, the life years and quality-adjusted life years (QALYs) of patients using PER vs. lacosamide (LCM) were estimated. Efficacy data were derived from clinical trials and the literature. Cost data (in US dollars) included drug costs and medical service costs. A lifetime horizon was adopted. Health outcomes and costs were discounted at an annual discount rate of 5%. Deterministic sensitivity analysis, probability sensitivity analysis, and scenario analysis were performed. The impact of the inclusion of PER in the NRDL on the medical insurance budget over 3 years (2021–2023) was also estimated.Results: Cost-effectiveness analysis indicates that 8 mg/day of PER increases QALYs by 0.054 and saves costs by $2,390 compared with 400 mg/day of LCM. 4 mg/day of PER increases QALYs by 0.010 and saves costs by $860 compared with 200 mg/day of LCM. Deterministic sensitivity analysis reveals that utility value and the extreme discount rate are the factors with the greatest impact on the incremental cost-effectiveness ratio. Probabilistic sensitivity analysis and scenario analysis show that the results are robust. Budget impact analysis indicates that after inclusion of PER in the NRDL, the incremental budget would be $1.28, $2.83, and $4.56 million from 2021 to 2023, respectively, but covering more eligible epileptic patients in the same time (1,918, 4,287, and 8,983, respectively).Conclusion: PER (8 or 4 mg/day) is of relatively high value as an add-on therapeutic regimen for partial-onset seizures in China because of its dominate advantage of cost-effectiveness over LCM and acceptable budget impact.

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Section: Discussionmentioning

confidence: 99%

Section: Uncertainty Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Value of Perampanel as Adjunctive Treatment for Partial-Onset Seizures in Epilepsy: Cost-Effectiveness and Budget Impact Analysis

Zhang

Ding

et al. 2021

Front. Public Health

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Systematic literature review of the humanistic and economic burden of focal epilepsy and primary generalized tonic–clonic seizures in adults

Boccaletti,

Lucas,

Nixon

et al. 2024

Epilepsia Open

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This systematic literature review (SLR) assessed the humanistic and economic burden of focal epilepsy and primary generalized tonic–clonic seizures (PGTCS) in adults to evaluate these domains in both populations and identify evidence gaps to inform future research. A search was conducted on December 7, 2022, using MEDLINE and Embase to identify studies published from 2012 onwards reporting humanistic burden (patient‐reported or caregiver‐reported outcomes or utilities, qualitative evaluations), economic burden (productivity loss, caregiver and societal costs of epilepsy), and sleep‐related outcomes. Of the 2830 citations identified, 136 were included. Most studies were in the focal epilepsy population; very few studies reported outcomes in the PGTCS population. The presence of epilepsy‐specific instruments varied based on the domain evaluated. Epilepsy exerted considerable humanistic and economic burden. Indicators of poor disease control (e.g., high seizure frequency, resistance to anti‐seizure medications, polypharmacy) increased epilepsy burden. Seizure frequency and type, disease severity, and polypharmacy also affected work productivity. Adults with epilepsy, particularly focal epilepsy, reported higher indirect costs, more sick days accrued, and early entry into retirement. Caregivers similarly reported high productivity loss and absenteeism related to caregiving duties. The results of this SLR highlight the high humanistic and economic burden of focal epilepsy and PGTCS, although limited data were available for the PGTCS population. The results include patient‐reported outcome data specific to focal epilepsy and PGTCS, expanding the limited humanistic burden evidence identified in previous reviews, and show the effect of poor disease control on individuals' lives and as a driver of indirect costs.Plain Language SummaryOur systematic literature review identified studies that evaluated the impact of focal epilepsy and primary generalized tonic–clonic seizures on patients and their caregivers. We found that focal epilepsy negatively impacted patients' mental health and sleep and was associated with higher indirect costs and lower work productivity in people with more severe disease. The impact of primary generalized tonic–clonic seizures on patients was rarely reported, and future research is needed.

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Pharmacoeconomics

Dodel

Kruse²,

Conrads-Frank³

et al. 2022

NeuroPsychopharmacotherapy

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Cost-effectiveness of perampanel for the treatment of primary generalized tonic-clonic seizures (PGTCS) in epilepsy: A Spanish perspective

Cited by 11 publications

References 19 publications

Value of Perampanel as Adjunctive Treatment for Partial-Onset Seizures in Epilepsy: Cost-Effectiveness and Budget Impact Analysis

Value of Perampanel as Adjunctive Treatment for Partial-Onset Seizures in Epilepsy: Cost-Effectiveness and Budget Impact Analysis

Systematic literature review of the humanistic and economic burden of focal epilepsy and primary generalized tonic–clonic seizures in adults

Pharmacoeconomics

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