AbobotulinumtoxinA and rehabilitation vs rehabilitation alone in post-stroke spasticity: An cost-utility analysis
Year: 2019
Type: article
Abstract: Using a tool named cost-utility analysis, this study investigated whether rehabilitation combined with a given drug (abobotulinumtoxinA) for post-stroke spasticity is cost-effective (i.e.affordable) vs rehabilitation alone for both the Italian National Health Service and society.Over a period of 2 years, this study shows that each additional year weighted for health-related quality of life (quality-adjusted life year; QALY) gained via rehabilitation combined with abobotulinumtoxinA vs rehabilitation alone for post-stroke spasticity costs the Italian National Health Service and society €12,341 and €23,601, respectively (2018 values).Given the Italian informal acceptability range (i.e. the maximum amount decisionmakers are supposed to pay) for additional QALY gained (€25,000-40,000), these results support the conclusion that rehabilitation combined with abobotulinumtoxinA is a cost-effective (i.e.good value for money) healthcare programme for treating patients with post-stroke spasticity in Italy.Objective: To investigate costs and quality-adjusted life years of rehabilitation combined with abobotuli-numtoxinA (aboBoNT-A) (rehab/aboBoNT-A) vs rehabilitation alone (rehab) in post-stroke spasticity in Italy.Design: Based on both Italian National Health Service and societal perspectives, a 2-year cost-utility analysis model was performed.Subject/patients: The cost-utility analysis model considered hypothetical patients.Methods: The cost-utility analysis model was populated with data concerning demographics, disease severity, healthcare and non-healthcare resource consumption.Data were collected via a questionnaire administered to 3 highly experienced Italian physiatrists (864 out of 930 post-stroke spasticity patients on rehab/aboBoNT-A in total).Costs are expressed in Euro (€) based on the year 2018.Results: The cost to society (rounded to the nearest whole €) was €22,959 (rehab/aboBoNT-A) vs €11,866 (rehab).Italian National Health Servicefunded cost was €7,593 (rehab/aboBoNT-A) vs €1,793 (rehab).Over a period of 2 years rehab/ aboBoNT-A outperforms rehab in terms of qualityadjusted life years gained (1.620 vs 1.150).The incremental cost-utility ratio was €12,341 (Italian National Health Service viewpoint) and €23,601 (societal viewpoint).Sensitivity analyses confirmed the robustness of the baseline results.Conclusion: Despite some limitations, the higher number of quality-adjusted life years gained vs rehab and the high probability of reaching a cost-utility ratio lower than the Italian informal acceptability range (€25,000-40,000) make rehab/aboBoNT-A a cost-effective healthcare programme for treating patients with post-stroke spasticity in Italy.
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,887
Funder: Ipsen
OpenAlex ID: W2995865387