Pharmacoeconomic considerations in treatment options for acute seizures.
Two pharmacoeconomic studies on the treatment of acute seizures have been conducted. In 1991, Kriel and colleagues surveyed parents of children with a history of cluster seizures, prolonged seizures, or status epilepticus who had been instructed in the use of rectal diazepam. A comparison of data before instruction with data after instruction showed a reduced need for emergency department visits with rectal diazepam. Instruction thus provided a pharmacoeconomic benefit, despite the cost of the product. In 1996, Marchetti and coworkers found that intravenous fosphenytoin was associated with fewer adverse events than intravenous phenytoin. Fosphenytoin thus reduced the need for adverse event management and provided a substantial pharmacoeconomic benefit, despite its higher cost, compared with phenytoin. This study had a number of limitations, however, and hospital pharmacists remain resistant to the use of fosphenytoin. Additional studies may provide more pharmacoeconomic data to support the greater use of fosphenytoin in the treatment of acute pediatric seizures.
Graves
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University of Minnesota College of Pharmacy, Minneapolis 55455, USA.
D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003975:Diazepam / Q000191:economics* / Q000627:therapeutic use; D017850:Economics, Pharmaceutical; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010353:Patient Education as Topic; D010672:Phenytoin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy* / Q000191:economics
D000927:Anticonvulsants; D010672:Phenytoin; C043114:fosphenytoin; D003975:Diazepam