[Cost-minimisation analysis of the pharmacological treatment of epilepsy in Spain]. / Análisis de minimización de costes del tratamiento farmacológico antiepiléptico en España.

AIM: To use a model of economic evaluation to analyse the efficiency of therapy with the antiepileptic drugs indicated in recently diagnosed partial and generalised epilepsy. MATERIALS AND METHODS: The treatment of partial epilepsy and generalised epilepsy in Spain was taken as the basis to design two flexible simulation models of the decision tree type. The time horizon of the study was one year and the perspective was that of the Spanish National Health System, and indirect costs were also included. Clinical effectiveness data were obtained from a review of the literature on clinical trials. Information about resources was obtained from the opinions of a panel of experts. Unitary costs of resources were drawn from Spanish databases (euro 2003). The findings of the study were expressed in terms of average cost per patient with each therapeutic strategy, as well as the incremental cost of the different treatment strategies with respect to valproic acid. RESULTS: According to the literature that was reviewed, there are no differences in effectiveness from one antiepileptic drug to another. The incremental cost of the different therapeutic strategies, with respect to valproic acid, lies between 211 and 911 euros per patient and year in partial epilepsy, and between 1,355 and 1,297 euros per patient and year in the case of generalised epilepsy. CONCLUSIONS: The use of sustained-release valproic acid in recently diagnosed partial and generalised epilepsy would allow savings to be made in resources, with respect to the other antiepileptic drugs, and can therefore be considered to be the most effective therapeutic option.

Análisis de minimización de costes del tratamiento farmacológico antiepiléptico en España / Cost-minimisation analysis of the pharmacological treatment of epilepsy in spain

Objetivo. Analizar mediante un modelo de evaluación económica la eficiencia del tratamiento con los fármacos antiepilépticos indicados en la epilepsia parcial y generalizada de reciente diagnóstico. Materiales y métodos. Se diseñaron dos modelos de simulación flexible del tipo árbol de decisión, basados en el tratamiento de la epilepsia parcial y la epilepsia generalizada en España. El horizonte temporal del estudio fue de un año y la perspectiva fue la del Sistema Nacional de Salud, con inclusión también de los costes indirectos. Los datos de eficacia clínica se obtuvieron de una revisión de la bibliografía de ensayos clínicos. La información sobre uso de recursos se obtuvo de la opinión de un panel de expertos. Los costes unitarios de los recursos se extrajeron de bases de datos españolas (euro 2003). Los resultados del estudio se expresaron como coste medio por paciente con cada estrategia de tratamiento, y como coste incremental de las diferentes estrategias de tratamiento respecto al ácido valproico. Resultados. Según la bibliografía revisada, no existen diferencias en eficacia entre los fármacos antiepilépticos. El coste incremental de las diferentes estrategias de tratamiento respecto al ácido valproico se sitúa entre los 211 y 911 euros por paciente al año en epilepsia parcial, y entre 1.355 y 1.297 euros por paciente al año en epilepsia generalizada. Conclusión. La utilización de ácido valproico de liberación prolongada en la epilepsia parcial y generalizada de reciente diagnóstico supondría un ahorro de recursos respecto a los demás fármacos antiepilépticos; por tanto, puede considerarse la opción terapéutica más eficiente (AU)

Aim. To use a model of economic evaluation to analyse the efficiency of therapy with the antiepileptic drugs indicated in recently diagnosed partial and generalised epilepsy. Materials and methods. The treatment of partial epilepsy and generalised epilepsy in Spain was taken as the basis to design two flexible simulation models of the decision tree type. The time horizon of the study was one year and the perspective was that of the Spanish National Health System, and indirect costs were also included. Clinical effectiveness data were obtained from a review of the literature on clinical trials. Information about resources was obtained from the opinions of a panel of experts. Unitary costs of resources were drawn from Spanish databases (euro 2003). The findings of the study were expressed in terms of average cost per patient with each therapeutic strategy, as well as the incremental cost of the different treatment strategies with respect to valproic acid. Results. According to the literature that was reviewed, there are no differences in effectiveness from one antiepileptic drug to another. The incremental cost of the different therapeutic strategies, with respect to valproic acid, lies between 211 and 911 euros per patient and year in partial epilepsy, and between 1,355 and 1,297 euros per patient and year in the case of generalised epilepsy. Conclusions. The use of sustained-release valproic acid in recently diagnosed partial and generalised epilepsy would allow savings to be made in resources, with respect to the other antiepileptic drugs, and can therefore be considered to be the most effective therapeutic option (AU)