title: Cost-minimization analysis in the treatment of spasticity in children with cerebral palsy with botulinum toxin type A: an observational, longitudinal, retrospective study.
abstract: OBJECTIVE
  Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy.
  
  
  METHODS
  A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital. A longitudinal analysis of spasticity severity was made to confirm the similar efficacy of both treatments. Cost minimization was analyzed using the dose administered and the direct costs (pharmacological and medical visits costs) from the perspective of the National Health System (in euros from 2016).
  
  
  RESULTS
  We analyzed 895 patients with paediatric spasticity: 543 were treated only with onabotulinumtoxinA, 292 only with abobotulinumtoxinA, and 60 with both treatments. The mean doses administered were 5.44 U/kg (SD = 2.17) for onabotulinumtoxinA, and 14.73 U/kg (5.26) for abobotulinumto xinA. The total annual direct cost (pharmacological and medical visits) was € 839.56 for onabotulinumtoxinA and € 631.23 for abobotulinumtoxinA, which represents a difference of € 208.34 per year in favour of treatment with abobotulinumtoxinA.
  
  
  CONCLUSIONS
  It has been demonstrated that in real clinical practice, the cost per patient and year for treatment of paediatric spasticity was lower when abobotulinumtoxinA was used.
authors: Ipsen Pharma S.A., Barcelona.. gloria.tapias@ipsen.com.
authors: Gloria
authors: G
authors: Tapias
authors: Paediatric Neurology Unit, Hospital Universitario Materno Infantil La Paz, Madrid.. yambee@hotmail.com.
authors: Mar
authors: M
authors: García-Romero
authors: Department of Health Economics and Outcomes Research, Oblikue Consulting S.L., Barcelona. Department of Statistics, Universitat de Barcelona, Barcelona. Spain.. ccrespo@uoc.edu.
authors: Carlos
authors: C
authors: Crespo
authors: Department of Health Economics and Outcomes Research, Oblikue Consulting S.L., Barcelona.. maribel.cuesta@oblikue.com.
authors: Maribel
authors: M
authors: Cuesta
authors: Department of Health Economics and Outcomes Research, Oblikue Consulting S.L., Barcelona.. carles.forne@oblikue.com.
authors: Carles
authors: C
authors: Forné
authors: 2Paediatric Neurology Unit, Hospital Universitario Materno Infantil La Paz, Madrid.. ipascual@salud.madrid.org.
authors: Samuel Ignacio
authors: SI
authors: Pascual-Pascual
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003363:Cost Control / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000191:economics* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA