Titre du document / Document title

Cost-effectiveness of add-on lamotrigine therapy in clinical practice

Auteur(s) / Author(s)

KNOESTER P. D. ⁽¹⁾ ; BOENDERMAKER A. J. ⁽²⁾ ; EGBERTS A. C. G. ⁽³⁾ ; HEKSTER Y. A. ⁽¹⁾ ; KEYSER A. ⁽⁴⁾ ; SEVERENS J. L. ⁽²⁾ ; RENIER W. O. ⁽⁴⁾ ; DECKERS C. L. P. ⁽⁵⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Clinical Pharmacy, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, PAYS-BAS
⁽²⁾ University Maastricht, Department of Health Organisation, Policy and Economics, Maastricht, PAYS-BAS
⁽³⁾ Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80082, 3508 TB Utrecht, PAYS-BAS
⁽⁴⁾ Department of Neurology, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, PAYS-BAS
⁽⁵⁾ Dutch Epilepsy Clinics Foundation, Location Heemslaete, Dr. Denekampweg 20, 8025 BV Zwolle, PAYS-BAS

Résumé / Abstract

Objective: This retrospective study addresses the cost-effectiveness of add-on therapy with lamotrigine in clinical practice. Methods: Two years' observational data of 165 patients were used. Seizure frequency, adverse effects and direct medical costs were recorded for the year before and the year after the start of lamotrigine add-on therapy. Therapy effectiveness was measured by: (1) reduction in seizure frequency and (2) retention time. The incremental cost-effectiveness ratio expressed the direct medical cost per patient treated effectively with lamotrigine. Results: The cost of medication was ?492 (95% CI: ?399-583) higher after the start of lamotrigine therapy. The extra cost of lamotrigine therapy (?622) was partly offset by a reduction of the cost of co-medication (-?130; 95% CI: -?210 to -?50). Overall, the total medical cost was ?453 higher in the first year of lamotrigine therapy than in the year before the start of lamotrigine. Lamotrigine was effective in 47% of all the patients, making the resultant incremental cost-effectiveness ratio ?954 per year. Discussion: Add-on therapy of lamotrigine for patients with uncontrolled epilepsy offers improved health outcomes. Lamotrigine therapy is associated with increased cost (?453) and an annual incremental cost-effectiveness ratio of ?954. These data, together with utility data published in the literature, support the notion that lamotrigine should be considered as an add-on therapy in for patients with refractory epilepsy.

Revue / Journal Title

Epilepsy research   ISSN 0920-1211   CODEN EPIRE8 

Source / Source

2005, vol. 67, n^o3, pp. 143-151 [9 page(s) (article)] (31 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Amsterdam, PAYS-BAS  (1987) (Revue)

Mots-clés anglais / English Keywords

Nervous system diseases ; Central nervous system disease ; Cerebral disorder ; Triazine derivatives ; Anticonvulsant ; Refractory ; Prognosis ; Chemotherapy ; Costs ; Frequency effect ; Human ; Retrospective ; Treatment ; Lamotrigine ; Cost efficiency analysis ; Epilepsy ;

Mots-clés français / French Keywords

Système nerveux pathologie ; Système nerveux central pathologie ; Encéphale pathologie ; Triazine dérivé ; Anticonvulsivant ; Réfractaire ; Pronostic ; Chimiothérapie ; Coût ; Effet fréquence ; Homme ; Rétrospective ; Traitement ; Lamotrigine ; Analyse coût efficacité ; Epilepsie ;

Mots-clés espagnols / Spanish Keywords

Sistema nervioso patología ; Sistema nervosio central patología ; Encéfalo patología ; Triazina derivado ; Anticonvulsivante ; Refractario ; Pronóstico ; Quimioterapia ; Coste ; Efecto frecuencia ; Hombre ; Retrospectiva ; Tratamiento ; Lamotrigina ; Análisis costo eficacia ; Epilepsia ;

Mots-clés d'auteur / Author Keywords

Lamotrigine ; Cost-effectiveness ; Observational ; Retrospective ;

Localisation / Location

INIST-CNRS, Cote INIST : 21149, 35400013525903.0070