Economic evaluation of levetiracetam as an add-on therapy in patients with refractory epilepsy.

Abstract:

OBJECTIVES:This study provides the results of a cost-effectiveness analysis of levetiracetam as an adjunctive treatment for refractory epilepsy from the Canadian Ministry of Health perspective. The main objective is to estimate the expected cost-effectiveness ratio expressed as the incremental cost per seizure-free day gained when using levetiracetam. In addition, this study examines the potential savings that might result by reducing the number of surgical evaluations and surgery when using levetiracetam. METHODS:A 1-year dose escalation decision-tree model comparing levetiracetam plus standard therapy with standard therapy alone was designed in order to combine probability, resource use and unit cost data (1999 Canadian dollars [$Can]). The short-term outcomes were derived from three phase III randomised, double-blind, placebo-controlled trials performed in 904 patients, aged 16-70 years, with at least 1 year history of epilepsy, two to four partial seizures per month, and receiving a maximum of two classic antiepileptic drugs. RESULTS:The average gain in seizure-free days attributed to levetiracetam was 19 days per patient per year and the incremental cost-effectiveness ratio (ICER) for levetiracetam add-on in the base-case scenario was $Can80.7 per seizure-free day gained per patient per year. Moreover, when surgical investigation and surgery are considered in the model, the use of levetiracetam may be dominant, with substantial savings to the overall healthcare budget. All univariate sensitivity analyses show that the model was robust to the assumptions made. CONCLUSIONS:The economic analysis presented in this paper suggests, given a wide range of assumptions, that the increased cost of treating patients (with refractory epilepsy) with levetiracetam may be partially offset by a reduction in other direct medical costs (from the Canadian Ministry of Health perspective), as a consequence of an increase in the number of seizure-free days. Moreover, potential cost savings may be foreseen when it is assumed that levetiracetam may reduce the number of candidates for surgical evaluation and surgery through a reduction of seizure frequency.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Blais L,Sheehy O,St-Hilaire JM,Bernier G,Godfroid P,LeLorier JJ

doi

10.2165/00019053-200523050-00008

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

493-503

issue

5

eissn

1170-7690

issn

1179-2027

pii

2358

journal_volume

23

pub_type

杂志文章
  • Correction to: A Budget Impact and Cost Per Additional Responder Analysis for Baricitinib for the Treatment of Moderate-to-Severe Rheumatoid Arthritis in Patients with an Inadequate Response to Tumor Necrosis Factor Inhibitors in the USA.

    abstract::Due to a single error in the annual cost of sarilumab the following needs to be corrected in the article. ...

    journal_title:PharmacoEconomics

    pub_type: 已发布勘误

    doi:10.1007/s40273-019-00857-7

    authors: Wehler E,Boytsov N,Nicolay C,Herrera-Restrepo O,Kowal S

    更新日期:2020-01-01 00:00:00

  • Decision analysis in formulary decision making.

    abstract::Although decision making about what drugs to include in an institutional formulary appears to lend itself readily to quantitative techniques such as decision analysis and cost-benefit analysis, a review of the literature reveals that very little has been published in this area. Several of the published decision analy...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199303060-00005

    authors: Schechter CB

    更新日期:1993-06-01 00:00:00

  • Economic Evaluations of Pharmaceuticals Granted a Marketing Authorisation Without the Results of Randomised Trials: A Systematic Review and Taxonomy.

    abstract:BACKGROUND:Pharmaceuticals are usually granted a marketing authorisation on the basis of randomised controlled trials (RCTs). Occasionally the efficacy of a treatment is assessed without a randomised comparator group (either active or placebo). OBJECTIVE:To identify and develop a taxonomic account of economic modellin...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-016-0460-6

    authors: Hatswell AJ,Freemantle N,Baio G

    更新日期:2017-02-01 00:00:00

  • Choice of cost-effectiveness measure in the economic evaluation of cholesterol-modifying pharmacotherapy. An illustrative example focusing on the primary prevention of coronary heart disease in Canada.

    abstract:OBJECTIVE:To evaluate the effect of using different cost-effectiveness measures in the economic evaluation of cholesterol-modifying pharmacotherapy. DESIGN AND SETTING:An economic model was used to examine the extent to which the relative cost effectiveness of cholesterol-modifying agents varies depending upon the cos...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199916020-00008

    authors: Morris S,Godber E

    更新日期:1999-08-01 00:00:00

  • Follow-up lipid tests and physician visits are associated with improved adherence to statin therapy.

    abstract:INTRODUCTION AND OBJECTIVE:The National Cholesterol Education Program recommends regular physician follow-up and lipid testing to promote adherence with lipid-lowering medications. The objective of this study was to determine whether lipid tests and physician visits after treatment initiation are indeed associated with...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00019053-200422003-00003

    authors: Benner JS,Tierce JC,Ballantyne CM,Prasad C,Bullano MF,Willey VJ,Erbey J,Sugano DS

    更新日期:2004-01-01 00:00:00

  • Economic Evaluation of Implementing a Novel Pharmacogenomic Test (IDgenetix®) to Guide Treatment of Patients with Depression and/or Anxiety.

    abstract:BACKGROUND:The response to therapeutics varies widely in patients with depression and anxiety, making selection of an optimal treatment choice challenging. IDgenetix®, a novel pharmacogenomic test, has been shown to improve outcomes by predicting the likelihood of response to different psychotherapeutic medications. O...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-017-0587-0

    authors: Najafzadeh M,Garces JA,Maciel A

    更新日期:2017-12-01 00:00:00

  • Epidemiology, therapy and costs of nosocomial infection.

    abstract::In the current climate of cost containment and quality control, nosocomial infection is a worrisome adverse event in hospital care. Hospitalised patients require care for increasingly severe illnesses, and are therefore more susceptible to infection, especially by opportunistic micro-organisms. It is thus necessary to...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199507020-00005

    authors: Gálvez-Vargas R,Bueno-Cavanillas A,García-Martín M

    更新日期:1995-02-01 00:00:00

  • The role of pharmacoeconomic evaluations in disease management.

    abstract::Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage over the current component...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199814010-00002

    authors: Chang K,Nash D

    更新日期:1998-07-01 00:00:00

  • Economic aspects of pneumococcal pneumonia: a review of the literature.

    abstract::In this review, the economic aspects of pneumococcal pneumonia are analysed, including the costs, cost effectiveness and cost benefit of treatment and prevention. We identified eight cost-of-illness studies, 15 analyses comparing the costs of different treatment options and 15 economic evaluations of prevention that m...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200422110-00003

    authors: De Graeve D,Beutels P

    更新日期:2004-01-01 00:00:00

  • Applying recent findings to clinical care in type II diabetes.

    abstract::There is a global perspective to the economic consequences of diabetes, which is illustrated in the many publications now being produced on this subject. Because of the higher prevalence of type II diabetes, its impact is greater than that of type I diabetes in both developed and developing countries (but particularly...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199500081-00017

    authors: Williams R

    更新日期:1995-01-01 00:00:00

  • Personalized Medicine and Pay for Performance: Should Pharmaceutical Firms be Fully Penalized when Treatment Fails?

    abstract::In this article, we model the behavior of a pharmaceutical firm that has marketing authorization for a new therapy believed to be a candidate for personalized use in a subset of patients, but that lacks information as to why a response is seen only in some patients. We characterize the optimal outcome-based reimbursem...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-018-0619-4

    authors: Antoñanzas F,Rodríguez-Ibeas R,Juárez-Castelló CA

    更新日期:2018-07-01 00:00:00

  • Pazopanib for the first-line treatment of patients with advanced and/or metastatic renal cell carcinoma : a NICE single technology appraisal.

    abstract::The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of pazopanib hydrochloride (GlaxoSmithKline) to submit evidence of the clinical and cost effectiveness of the drug for the first-line treatment of advanced and/or metastatic renal cell carcinoma, as part of the Institute's single...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-012-0006-5

    authors: Kilonzo M,Hislop J,Elders A,Fraser C,Bissett D,McClinton S,Mowatt G,Vale L

    更新日期:2013-01-01 00:00:00

  • The value of clopidogrel in addition to standard therapy in reducing atherothrombotic events.

    abstract::The recent multinational, randomised, prospective studies Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE), Percutaneous Coronary Intervention substudy of CURE (PCI-CURE) and Clopidogrel for the Reduction of Events During Observation (CREDO) have demonstrated the clinical efficacy and safety of clopid...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,meta分析,多中心研究

    doi:10.2165/00019053-200422004-00006

    authors: Weintraub W,Jönsson B,Bertrand M

    更新日期:2004-01-01 00:00:00

  • Incorporation of statistical uncertainty in health economic modelling studies using second-order Monte Carlo simulations.

    abstract::Health economic modelling studies are of interest to many parties with different responsibilities and diverging interests. Therefore, it is obvious that recognising the relevance of statistical uncertainty and dealing with it appropriately are required to obtain unbiased results from health economic modelling studies,...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200422120-00001

    authors: Nuijten MJ

    更新日期:2004-01-01 00:00:00

  • Oral ciprofloxacin: a pharmacoeconomic evaluation of its use in the treatment of serious infections.

    abstract::The broad spectrum of antibacterial activity and favourable pharmacokinetic profile of ciprofloxacin permit oral treatment of many serious infections which have traditionally necessitated parenteral antibacterial therapy. This has been demonstrated in comparative studies, in which ciprofloxacin was as effective and w...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-199303050-00007

    authors: Balfour JA,Faulds D

    更新日期:1993-05-01 00:00:00

  • Healthcare resource and lost labour costs of migraine headache in the US.

    abstract::Migraine headache is responsible for significantly more healthcare resource and lost labour costs than previously reported. Costs associated with migraine were assessed via a survey conducted in 940 patients, 70% of whom responded. All met the International Headache Society's diagnostic criteria for migraine and had ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199202010-00008

    authors: Osterhaus JT,Gutterman DL,Plachetka JR

    更新日期:1992-07-01 00:00:00

  • Having your cake and eating it: office of fair trading proposal for funding new drugs to benefit patients and innovative companies.

    abstract::There are insufficient resources in the UK to fund all new technologies and new indications approved by the National Institute for Health and Clinical Excellence (NICE). Diverting funding from existing sources will have a detrimental effect on the provision of other priority services. The UK Office of Fair Trading (OF...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200826020-00001

    authors: Godman B,Haycox A,Schwabe U,Joppi R,Garattini S

    更新日期:2008-01-01 00:00:00

  • Review of cost-benefit analyses of influenza vaccine.

    abstract::Vaccination is an underutilised, low cost and effective method of preventing illness. Cost-effectiveness analysis discloses a beneficial role of influenza vaccination in preventing illness especially in patients over 65 years of age and in high risk patients. In one large study, when 150 million doses of influenza v...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199202030-00003

    authors: Perez-Tirse J,Gross PA

    更新日期:1992-09-01 00:00:00

  • Comparing dihydroergotamine mesylate and sumatriptan in the management of acute migraine. A retrospective cost-efficacy analysis.

    abstract::The annual cost of managing migraine totals billions of US dollars. This retrospective economic analysis of a clinical trial comparing subcutaneous dihydroergotamine mesylate (DHE) with subcutaneous sumatriptan in the treatment of acute migraine is appropriate because, although each product has been shown to be effica...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00019053-199610010-00006

    authors: Payne K,Kozma CM,Lawrence BJ

    更新日期:1996-07-01 00:00:00

  • The applicability and generalizability of findings from clinical trials for health-policy decisions.

    abstract::Randomized controlled trials provide unbiased estimates of treatment effect through reducing the attribution of observed differences in outcome to the play of chance or the treatment of interest. Issues in the design of randomized trials may lead to a dilution or magnification of treatment effect when compared with cl...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200927010-00002

    authors: Freemantle N,Hessel F

    更新日期:2009-01-01 00:00:00

  • Cost-minimisation study of dorzolamide versus brinzolamide in the treatment of ocular hypertension and primary open-angle glaucoma: in four European countries.

    abstract:OBJECTIVE:Cost is an issue when prescribing two drugs with equivalent efficacy. We compared the direct medical costs of topical brinzolamide 1% (twice a day or three times daily) with topical dorzolamide 2% (twice a day or three times daily) in France, Italy, Portugal and Spain in patients with ocular hypertension or p...

    journal_title:PharmacoEconomics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00019053-200321030-00005

    authors: Rouland JF,Le Pen C,Gouveia Pinto C,Berto P,Berdeaux G

    更新日期:2003-01-01 00:00:00

  • Economic evaluation of insulin lispro versus neutral (regular) insulin therapy using a willingness-to-pay approach.

    abstract::This willingness-to-pay (WTP) analysis is the first study of its kind undertaken in Australia to support an application for listing of a new drug on the Australian national formulary. The technique offers the advantage of being able to summarise diverse outcomes of therapy in a single unit of measure. Willingness to p...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199813030-00009

    authors: Davey P,Grainger D,MacMillan J,Rajan N,Aristides M,Dobson M

    更新日期:1998-03-01 00:00:00

  • A review of the psychometric properties of generic utility measures in multiple sclerosis.

    abstract:OBJECTIVE:The reliability and validity of generic utility measures have not yet been summarized in people with multiple sclerosis (MS). It is important to assess the psychometric properties of these measures, to ensure that the values obtained by the scoring system are valid for interpretation and utilization by clinic...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.1007/s40273-014-0167-5

    authors: Kuspinar A,Mayo NE

    更新日期:2014-08-01 00:00:00

  • Cost effectiveness of fluvoxamine in the treatment of recurrent depression in France.

    abstract:OBJECTIVE:The objective of this study was to examine the cost effectiveness of fluvoxamine compared with tricyclic antidepressants (TCAs) in the treatment of patients with depressive episodes. DESIGN AND SETTING:A Markov process model was constructed to model the effectiveness, as measured by time without depression, ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-199814040-00009

    authors: Nuijten M,Hadjadjeba L,Evans C,van den Berg J

    更新日期:1998-10-01 00:00:00

  • Concepts of 'personalization' in personalized medicine: implications for economic evaluation.

    abstract:CONTEXT:This study assesses if, and how, existing methods for economic evaluation are applicable to the evaluation of personalized medicine (PM) and, if not, where extension to methods may be required. METHODS:A structured workshop was held with a predefined group of experts (n = 47), and was run using a modified nomi...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.1007/s40273-014-0211-5

    authors: Rogowski W,Payne K,Schnell-Inderst P,Manca A,Rochau U,Jahn B,Alagoz O,Leidl R,Siebert U

    更新日期:2015-01-01 00:00:00

  • Economic evaluation in the US: what is the missing link?

    abstract::In this paper we consider the evolving American healthcare landscape and what it means for the use of economic evaluation of health interventions. We emphasise that use of economic evaluation in the US is unlikely to follow the European, Canadian or Australian models, which use cost effectiveness openly and explicitly...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章,评审

    doi:10.2165/00019053-200624110-00012

    authors: Neumann PJ,Sullivan SD

    更新日期:2006-01-01 00:00:00

  • Incorporation of uncertainty in health economic modelling studies.

    abstract::In a recent leading article in PharmacoEconomics, Nuijten described some methods for incorporating uncertainty into health economic models and for utilising the information on uncertainty regarding the cost effectiveness of a therapy in resource allocation decision-making. His proposals are found to suffer from seriou...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200523060-00001

    authors: O'Hagan A,McCabe C,Akehurst R,Brennan A,Briggs A,Claxton K,Fenwick E,Fryback D,Sculpher M,Spiegelhalter D,Willan A

    更新日期:2005-01-01 00:00:00

  • Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

    abstract::The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements fo...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200220070-00002

    authors: Oostenbrink JB,Koopmanschap MA,Rutten FF

    更新日期:2002-01-01 00:00:00

  • Cost effectiveness of epoetin-alpha to augment preoperative autologous blood donation in elective cardiac surgery.

    abstract:OBJECTIVE:The objective of this study was to assess the cost effectiveness of using epoetin-alpha (erythropoietin) to augment preoperative autologous donation (PAD) of blood prior to elective cardiac surgery. DESIGN AND SETTING:We designed a decision-analytic model incorporating the risk of receiving allogeneic blood,...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200018020-00006

    authors: Coyle D,Lee KM,Fergusson DA,Laupacis A

    更新日期:2000-08-01 00:00:00

  • Cost effectiveness of trastuzumab in the adjuvant treatment of early breast cancer: a lifetime model.

    abstract:BACKGROUND:Recent randomised trials have demonstrated a statistically significant effect of trastuzumab on disease-free survival when used as adjuvant therapy for human epidermal growth factor receptor 2 protein (HER2)-positive resectable early stage breast cancer, with a treatment course lasting either 9 or 52 weeks. ...

    journal_title:PharmacoEconomics

    pub_type: 杂志文章

    doi:10.2165/00019053-200725050-00006

    authors: Millar JA,Millward MJ

    更新日期:2007-01-01 00:00:00