title: Cost-effectiveness of Sativex in multiple sclerosis spasticity: new data and application to Italy.
abstract: Multiple sclerosis (MS) is a chronic progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and contributes to MS-related disability. This study aims to evaluate the cost-effectiveness of Sativex(®) (9-delta-tetrahydrocannabinol plus cannabidiol oromucosal spray) when used as add-on therapy for management of resistant MS-related spasticity in the context of the Italian healthcare system. A previously published Markov model-based analysis for the German and Spanish context was replicated, adapting it to the Italian setting. Model parameters were updated to reflect recent findings about MS-related spasticity and use of Sativex in daily clinical practice. The base case incremental cost-effectiveness ratio for Sativex use in Italy over a 5-year period was estimated to be €4968 per quality-adjusted life-year gained (year of costing: 2013). Sativex remained an efficient option in the Italian healthcare context - below the commonly accepted incremental threshold of €30,000 per quality-adjusted life-year gained - when deterministic and probabilistic sensitivity analyses were conducted. Sativex can be regarded as a cost-effective treatment option for patients with MS-related spasticity in Italy.
authors.affiliation: Universitat Autònoma de Barcelona, Campus de la UAB, 08193, Bellaterra, Spain.
authors.forename: John
authors.initials: J
authors.lastname: Slof
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ruiz
authors.forename: Carlos
authors.initials: C
authors.lastname: Vila
mesh_terms: D002185:Cannabidiol; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics; D013759:Dronabinol; D004338:Drug Combinations; D006801:Humans; D007558:Italy; 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
chemical_list: D004338:Drug Combinations; D010936:Plant Extracts; D002185:Cannabidiol; D013759:Dronabinol; C587251:nabiximols
keywords: Italy; Sativex; cost-effectiveness; multiple sclerosis; spasticity