title: A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis.
abstract: BACKGROUND
  Severity of spasticity in multiple sclerosis (MS) directly correlates with the level and cost of care required. This study assessed whether a tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray for treatment of moderate-severe MS spasticity is a cost-effective use of healthcare resources in Wales.
  
  
  METHODS
  A Markov model was developed to compare THC/CBD plus standard of care (SoC) treatments with SoC alone.
  
  
  RESULTS
  At 30 years, total incremental cost for THC/CBD plus SoC treatment was estimated at £3,836/patient (ICER: £10,891/quality-adjusted life year [QALY]). Hospital admission costs had the greatest effect on the base case ICER. Inclusion of carer cost led to incremental cost of -£33,609/patient (ICER: -£95,423/QALY).
  
  
  CONCLUSIONS
  The THC/CBD spray was found to be cost-effective for the treatment of spasticity in MS, and dominant, if home carer costs were included. Use of THC/CBD has the potential to generate cost savings by significantly improving the symptoms of moderate to severe MS spasticity.
authors.affiliation: a GfK , London , UK.
authors.forename: Adrien
authors.initials: A
authors.lastname: Gras
authors.affiliation: b Health Economics Outcomes Research , Bayer plc , Newbury , UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Broughton
mesh_terms: D000328:Adult; D002185:Cannabidiol / Q000008:administration & dosage* / Q000191:economics; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D013759:Dronabinol / Q000008:administration & dosage* / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014852:Wales
chemical_list: D002185:Cannabidiol; D013759:Dronabinol
keywords: Multiple sclerosis; pharmacoeconomics; resource utilization; spasticity; tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray; treatment costs