title: Budget impact analysis of botulinum toxin A therapy for upper limb spasticity in the United Kingdom.
abstract: BACKGROUND
  Botulinum toxin A (BoNT-A) is an effective treatment for patients with upper limb spasticity (ULS), which is a debilitating feature of upper motor neuron lesions. BoNT-A preparations available in the UK are associated with different costs.
  
  
  METHODS
  We developed a budget impact model to assess the effect of changing market shares of different BoNT-A formulations - abobotulinumtoxinA, onabotulinumtoxinA, and incobotulinumtoxinA - and best supportive care, from the UK payer perspective, over a 5-year time horizon. Epidemiological and resource use data were derived from published literature and clinical expert opinion. One-way sensitivity analyses were performed to determine parameters most influential on budget impact.
  
  
  RESULTS
  Base-case assumptions showed that an increased uptake of abobotulinumtoxinA resulted in a 5-year savings of £6,283,829. Treatment with BoNT-A costs less than best supportive care per patient per year, although treating a patient with onabotulinumtoxinA (£20,861) and incobotulinumtoxinA (£20,717) cost more per patient annually than with abobotulinumtoxinA (£19,800). Sensitivity analyses showed that the most influential parameters on budget were percentage of cerebral palsy and stroke patients developing ULS, and the prevalence of stroke.
  
  
  CONCLUSIONS
  Study findings suggest that increased use of abobotulinumtoxinA for ULS in the UK could potentially reduce total ULS cost for the health system and society.
authors: Meta Research, Evidera, London, UK.
authors: Seye
authors: S
authors: Abogunrin
authors: Health Economics, Evidera, London, UK.
authors: Linda
authors: L
authors: Hortobagyi
authors: Health Economics, Evidera, Budapest, Hungary, France.
authors: Edit
authors: E
authors: Remak
authors: Health Economics and Outcomes Research (Global), Ipsen Pharma, Boulogne-Billancourt, France.
authors: Jerome
authors: J
authors: Dinet
authors: Global Market Access and Pricing, Ipsen Pharma, Boulogne-Billancourt, France.
authors: Sylvie
authors: S
authors: Gabriel
authors: Neurological Rehabilitation, Moseley Hall Hospital, Birmingham, UK.
authors: Abdel Magid O
authors: AM
authors: Bakheit
keywords: cerebral palsy; multiple sclerosis; stroke; traumatic brain injury