Adjunctive stiripentol not costeffective in Canada

Adjunctive stiripentol not costeffective in Canada PharmacoEconomics & Outcomes News 804, p5 - 2 Jun 2018 Adjunctive stiripentol not cost effective in Canada At its current price, adjunctive stiripentol does not appear to be cost effective for the treatment of Dravet syndrome in Canada, according to findings of a cost- utility study published in Pharmacoeconomics. In Canada, stiripentol is approved for use in conjunction with clobazam and valproate in patients with Dravet syndrome whose seizures are resistant to treatment with clobazam and valproate alone. This study used a Markov model to evaluate the cost effectiveness of stiripentol as an adjunctive treatment to clobazam and valproate, compared with clobazam and valproate alone in children with inadequately controlled Dravet syndrome, from the perspective of the Canadian public healthcare payer over a 10-year time horizon. Patients were assumed to receive the maximum recommended Health Canada-approved dosage of each drug. Adjunctive stiripentol was estimated to achieve an incremental gain of 0.60 QALYs compared with clobazam and valproate alone, at an incremental cost of $91 080, resulting in an estimated incremental cost- effectiveness ratio of $151 310 per QALY gained. Drug costs accounted for 72% of total costs of adjunctive stirpentol ($99 062); other healthcare costs were $7982 lower with than with clobazam and valproate alone. At a willingness-to-pay threshold of $50 000 per QALY gained, the probability that stiripentol was the optimal treatment was only 5.2%. The cost of stiripentol would need to be reduced by 61.4% for it to become cost effective. "Stiripentol is currently funded in several Canadian provinces through special access programs. Although confidential agreements with manufacturers may have resulted in reduced prices, the price would need to be reduced by at least 60% to ensure that funding of stiripentol would not lead to a reduction in overall population health. Thus, the decision to cover stiripentol should be reconsidered in light of the likely high opportunity costs of this coverage," commented the authors. * 2017 Canadian dollars Elliot J, et al. Economic Evaluation of Stiripentol for Dravet Syndrome: A Cost- Utility Analysis. PharmacoEconomics : 15 May 2018. Available from: URL: https://doi.org/10.1007/s40273-018-0669-7 803322333 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png PharmacoEconomics & Outcomes News Springer Journals

Adjunctive stiripentol not costeffective in Canada

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Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Pharmacoeconomics and Health Outcomes; Quality of Life Research; Health Economics; Public Health
ISSN
1173-5503
eISSN
1179-2043
D.O.I.
10.1007/s40274-018-4969-0
Publisher site
See Article on Publisher Site

Abstract

PharmacoEconomics & Outcomes News 804, p5 - 2 Jun 2018 Adjunctive stiripentol not cost effective in Canada At its current price, adjunctive stiripentol does not appear to be cost effective for the treatment of Dravet syndrome in Canada, according to findings of a cost- utility study published in Pharmacoeconomics. In Canada, stiripentol is approved for use in conjunction with clobazam and valproate in patients with Dravet syndrome whose seizures are resistant to treatment with clobazam and valproate alone. This study used a Markov model to evaluate the cost effectiveness of stiripentol as an adjunctive treatment to clobazam and valproate, compared with clobazam and valproate alone in children with inadequately controlled Dravet syndrome, from the perspective of the Canadian public healthcare payer over a 10-year time horizon. Patients were assumed to receive the maximum recommended Health Canada-approved dosage of each drug. Adjunctive stiripentol was estimated to achieve an incremental gain of 0.60 QALYs compared with clobazam and valproate alone, at an incremental cost of $91 080, resulting in an estimated incremental cost- effectiveness ratio of $151 310 per QALY gained. Drug costs accounted for 72% of total costs of adjunctive stirpentol ($99 062); other healthcare costs were $7982 lower with than with clobazam and valproate alone. At a willingness-to-pay threshold of $50 000 per QALY gained, the probability that stiripentol was the optimal treatment was only 5.2%. The cost of stiripentol would need to be reduced by 61.4% for it to become cost effective. "Stiripentol is currently funded in several Canadian provinces through special access programs. Although confidential agreements with manufacturers may have resulted in reduced prices, the price would need to be reduced by at least 60% to ensure that funding of stiripentol would not lead to a reduction in overall population health. Thus, the decision to cover stiripentol should be reconsidered in light of the likely high opportunity costs of this coverage," commented the authors. * 2017 Canadian dollars Elliot J, et al. Economic Evaluation of Stiripentol for Dravet Syndrome: A Cost- Utility Analysis. PharmacoEconomics : 15 May 2018. Available from: URL: https://doi.org/10.1007/s40273-018-0669-7 803322333 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804

Journal

PharmacoEconomics & Outcomes NewsSpringer Journals

Published: Jun 2, 2018

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