title: Cost-effectiveness analysis of antiepileptic drugs in the treatment of Lennox-Gastaut syndrome.
abstract: An economic model evaluated the costs and outcomes of adjunctive clobazam therapy for Lennox-Gastaut syndrome (LGS) compared with adjunctive lamotrigine, rufinamide, and topiramate. Clinical data were used to estimate baseline frequency and the percentage of drop-seizure reductions over 3 months (all comparators) and 2 years (rufinamide). Claims data from a large US health care plan were employed to estimate costs. After 3 months, 21.5% of those receiving clobazam were drop-seizure-free. Over a 3-month horizon, clobazam was more effective and less expensive than comparators, with the assumption that >0.77% of drop seizures required medical care. Below this threshold, topiramate was less costly than clobazam. With the base-case assumption that 2.3% of drop seizures were medically attended, costs for patients receiving clobazam totaled $30,147 versus $34,223-$35,378 for comparators. Clobazam was more efficacious and less costly than rufinamide over a 2-year horizon. The percentage of medically attended drop seizures was a driver of results. Clobazam treatment may be cost-saving.
authors: OptumInsight, Cambridge, MA, USA. Electronic address: karen.clements@optum.com.
authors: Karen M
authors: KM
authors: Clements
authors: Michelle
authors: M
authors: Skornicki
authors: Amy K
authors: AK
authors: O'Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy / Q000191:economics*; D065768:Lennox Gastaut Syndrome; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D011336:Probability; D012680:Sensitivity and Specificity; D013036:Spasms, Infantile / Q000188:drug therapy / Q000191:economics*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drug; Budget impact modeling; Clobazam; Cost effectiveness; Epilepsy; Lennox–Gastaut syndrome; Pharmacoeconomics