Sativex® in multiple sclerosis spasticity: a cost-effectiveness model.
BACKGROUND
Multiple sclerosis (MS) is a chronic, progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and a key contributor to MS-related disability.


OBJECTIVE
This study evaluated the cost-effectiveness of Sativex®, a 9-d-tetrahydrocannabinol/cannabidiol-based oromucosal spray that acts as an endocannabinoid system modulator. Sativex was recently approved for the management of resistant MS spasticity as add-on medication.


METHODS
A Markov model-based analysis was performed over a 5-year horizon from a German and Spanish healthcare payer perspective. The incremental cost of Sativex was low compared with current spasticity treatments, and provided a quality-adjusted life-year gain over the current standard of care.


RESULTS
The base-case incremental cost-effectiveness ratio for Sativex was estimated at €11,214/quality-adjusted life-year in Germany, while the drug was the dominant option in Spain, providing savings of €3496/patient over a 5-year period (year of costing: 2010). This was seen because the lower severity of spasticity in patients who had improved led to reduced resource consumption (e.g., physiotherapy and medications).


CONCLUSIONS
Despite having a relatively high acquisition cost, Sativex was shown to be a cost-effective treatment option for patients with MS-related spasticity.
Universitat Autònoma de Barcelona, Campus de la UAB, Bellaterra, Spain.
John
J
Slof
Adrien
A
Gras
D002185:Cannabidiol; D003362:Cost-Benefit Analysis; D013759:Dronabinol; D004338:Drug Combinations; D016527:Drug Costs; D004351:Drug Resistance; D005858:Germany; D006801:Humans; D008390:Markov Chains; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D010936:Plant Extracts / Q000191:economics / Q000627:therapeutic use*; D019057:Quality-Adjusted Life Years; D012720:Severity of Illness Index; D013030:Spain
D004338:Drug Combinations; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols