EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57

Abstract

COST-EFFECTIVENESS ANALYSIS (CEA) OF ANTIEPILEPTIC DRUG (AED) TREATMENT IN NEWLY DIAGNOSED PATIENTS WITH EPILEPSY: FINDINGS FROM A TERTIARY CARE HOSPITAL IN INDIA

Dr. Ranjana G., Dr. Kulkarni Chanda*, Dr. Sunita Nair and Dr. Sarma G. R. K.

ABSTRACT

Objective: To compare cost-effectiveness between newer vs older anti-epileptic drug (AED) treatment in patients with newly diagnosed epilepsy. Material and Methods: The socio-demographic data of patients with epilepsy (PWE), clinical characteristics and cost components were collected prospectively for 12 months. A decision analysis was carried out to compare cost-effectiveness of treatment strategies between older and newer AEDs with clobazam as add-on. We considered two outcome groups namely the complete success and the failure of seizure control. Results: There were 76 (43 males and 33 females) newly diagnosed PWE. Their median age at AED treatment initiation was 23 years (18-46 IQR 19-30) and 35(46%) were from lower/upper lower socioeconomic class. The probability of obtaining complete success varied from 73% with Carbamazepine (CBZ) - CBZ+CLB to 84% with Topiramate (TPM)-TPM+ Clobazam (CLB). Treatment strategy (CBZ) - CBZ+CLB) which recorded lowest cost was considered as reference cost. The expected annual total cost (direct + indirect cost) of treatment per patient during the first year were US$ 416.85; the total direct costs were US$351.45 and AED costs were US$26.17. The TPM-TPM+CLB was a non-dominated strategy, with ICER US$764.98 for total costs relative to CBZ-CBZ+CLB per additional patient with complete success. The AEDs for PHT, VPA, OXC, and LEV alone, and with CLB as add on were dominated (more costly, but less effective). ICER values with highest direct and total treatment cost estimates using one-way sensitivity analysis for CBZ and TPM were found to be non-dominated compared to least costly strategy PHT. However, the ICER value was not found to be cost-effective compared to WHO thresholds. Conclusion: The use of newer AED TPM alone and followed by CLB as add on strategy was found to be cost-effective compared to CBZ alone followed by CLB which is justified considering the GDP per capita.

Keywords: epilepsy, antiepileptic drugs (AEDs), patients with epilepsy (PWE), cost-effectiveness analysis (CEA), and decision tree model.


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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI )