Economic Value of Adjunctive Brivaracetam Treatment Strategy for Focal Onset Seizures in Finland

Abstract

Introduction: There is an unmet need for welltolerated antiepileptic drugs (AEDs) that effectively control focal onset seizures. This study aimed to evaluate the economic value of new AEDs in the treatment of focal onset seizure, with or without secondary generalization, in Finnish adults and adolescents with epilepsy, comparing brivaracetam with perampanel as adjunctive AEDs. Methods: Economic value was assessed using cost-utility analysis. Periods of AED initiation, titration, response assessment (seizure freedom, C 50% reduction, no response), switching in no response or treatment-emergent adverse events (TEAEs), and death were simulated using a discrete-event simulation model. Responses and switching were simulated based on a comprehensive Bayesian network meta-analysis. The primary modeled outcome was the 3%/year discounted incremental cost-effectiveness ratio (ICER). Discounted quality-adjusted life-years (QALYs), payer costs (year 2017 Euro) per patient, and net monetary benefit (NMB) were secondary outcomes. Probabilistic and comprehensive deterministic sensitivity analyses were conducted. Results: Brivaracetam was more efficacious and had fewer TEAEs than perampanel and other AEDs. Modeled average 5-year QALYs and costs were 3.671 and €28,297 for brivaracetam and 3.611 and €27,979 for perampanel, respectively. The resulting ICER for brivaracetam versus Enhanced Digital Features To view enhanced digital features for this article go to

A Systematic Review of the Cost-effectiveness of Perampanel in the Treatment of Epilepsy

“…Each study focused on a different population. Donger Zhang et al, studied patients with partial-onset seizures, Gabriel Tremblay et al, investigated primary generalized tonic-clonic seizures (PGTCS), and Saku Väätäinen et al focused on patients with focal onset seizures [12,14,15].…”

“…Meanwhile, Saku Väätäinen et al compared perampanel (4, 6, 8, 10, 12 mg/day) with Brivaracetam (100mg/day). Gabriel Tremblay et al 54 compared AEDs with and without perampanel [15]. Table 3.…”

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