[Analysis of cost minimization of monotherapy antiepileptic treatment in patients with recent diagnosed epilepsy : the situation in Spain].
OBJECTIVE
To analyze the cost of monotherapeutic treatment of patients with newly diagnosed epilepsy.


METHODS
We analysed the cost of treatment with lamotrigine (LTG), carbamazepine (CBZ), phenytoin (PHT) and valproic acid (VPA) using published data regarding the efficacy and tolerability of comparative clinical trials of monotherapy. We established a model of treatment for newly diagnosed patients during the first 12 months after diagnosis. A panel of doctors reached a consensus on the use of resources, costs and model of treatment in Spain. We made a cost minimization analysis for economic assessment of the data based on the fact that randomized trials indicated that CBZ, LTG, PHT and VPA ware of similar efficacy. Analysis was done as 'intention to treat'. Only direct medical costs were considered.


RESULTS
In Spain treatment with LTG is twice or three times as expensive as treatment with the other drugs. Sensitivity analysis showed that variations in the interval of use of resources and of costs (defined by the panel of doctors) did not significantly alter the results.


CONCLUSIONS
Treatment with LTG is more expensive than treatment with the classical drugs. In view of the methodological limitations of this study, further analysis is necessary, particularly of the methodology of cost-benefit, to evaluate the economic impact of the new antiepileptic drugs and determine whether their use is justified as drugs of first choice.
Arroyo
S
S
Departamento de Neurología, Hospital Clínico, Barcelona.
Fossas
P
P
Nieto-Barrera
M
M
Salas-Puig
X
X
Sánchez-Alvarez
J C
JC
Serratosa
J M
JM
Soler-Singla
L
L
Heaney
D C
DC
Sander
J W
JW
Shorvon
S
S
D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use; D002220:Carbamazepine / Q000191:economics / Q000627:therapeutic use; D002648:Child; D003362:Cost-Benefit Analysis; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D000077213:Lamotrigine; D010672:Phenytoin / Q000191:economics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D013030:Spain; D014227:Triazines / Q000191:economics / Q000627:therapeutic use; D014635:Valproic Acid / Q000191:economics / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin; D000077213:Lamotrigine