title: Budget impact analysis of adjunctive therapy with lacosamide for partial-onset epileptic seizures in Belgium.
abstract: OBJECTIVE
  This study aims to compute the budget impact of lacosamide, a new adjunctive therapy for partial-onset seizures in epilepsy patients from 16 years of age who are uncontrolled and having previously used at least three anti-epileptic drugs from a Belgian healthcare payer perspective.
  
  
  METHODS
  The budget impact analysis compared the 'world with lacosamide' to the 'world without lacosamide' and calculated how a change in the mix of anti-epileptic drugs used to treat uncontrolled epilepsy would impact drug spending from 2008 to 2013. Data on the number of patients and on the market shares of anti-epileptic drugs were taken from Belgian sources and from the literature. Unit costs of anti-epileptic drugs originated from Belgian sources. The budget impact was calculated from two scenarios about the market uptake of lacosamide.
  
  
  RESULTS
  The Belgian target population is expected to increase from 5333 patients in 2008 to 5522 patients in 2013. Assuming that the market share of lacosamide increases linearly over time and is taken evenly from all other anti-epileptic drugs (AEDs), the budget impact of adopting adjunctive therapy with lacosamide increases from €5249 (0.1% of reference drug budget) in 2008 to €242,700 (4.7% of reference drug budget) in 2013. Assuming that 10% of patients use standard AED therapy plus lacosamide, the budget impact of adopting adjunctive therapy with lacosamide is around €800,000-900,000 per year (or 16.7% of the reference drug budget).
  
  
  CONCLUSIONS
  Adjunctive therapy with lacosamide would raise drug spending for this patient population by as much as 16.7% per year. However, this budget impact analysis did not consider the fact that lacosamide reduces costs of seizure management and withdrawal. The literature suggests that, if savings in other healthcare costs are taken into account, adjunctive therapy with lacosamide may be cost saving.
authors.affiliation: Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Onderwijs en Navorsing 2, Herestraat 49, 3000 Leuven, Belgium. steven.simoens@pharm.kuleuven.be
authors.forename: Steven
authors.initials: S
authors.lastname: Simoens
mesh_terms: D000081:Acetamides / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D001530:Belgium; D002017:Budgets / Q000639:trends*; D016527:Drug Costs / Q000639:trends; D020937:Epilepsy, Partial, Sensory / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D000078334:Lacosamide
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide