Cost-effectiveness of clobazam as an adjunctive treatment for refractory epilepsy in China.

Abstract

Background: Clobazam (CLB) is an effective, safe and well-tolerated adjunctive treatment for refractory epilepsy. However, the cost-effectiveness of CLB in China remains unclear.

Aim: The aim of this study was to evaluate the cost-effectiveness of CLB as an adjunctive therapy for patients with refractory epilepsy in China.

Method: A Markov model was established to simulate the lifetime epilepsy process in patients. The epilepsy remission rate, health state utility and mortality data were derived from clinical trials and the literature. The costs were collected from the health care system in the hospital. The primary outcome was the incremental cost-effectiveness ratio (ICER), which was calculated by comparing CLB as an add-on therapy with conventional therapy and was assessed in the context of the Chinese health system. One-way and probabilistic sensitivity analyses were conducted to evaluate parameter uncertainty, and several scenario analyses were also conducted.

Results: Compared with maintaining conventional therapy, adding CLB as an adjuvant therapy increased the cost of Chinese Yuan (CNY) 1770.17 over a lifetime, with an incremental quality-adjusted life years (QALYs) value of 1.02, resulting in an ICER of CNY 1737.10 per QALY gained. The daily dose of CLB had the strongest effect on the ICER. The probabilistic sensitivity analyses revealed that the probability of CLB being cost-effective was 77.35% at a willingness to pay (WTP) of CNY 85698/QALY.

Conclusion: CLB is a cost-effective add-on therapy for refractory epilepsy in the Chinese population.