Objective: To investigate costs and quality-adjusted life years of rehabilitation combined with abobotuli-numtoxinA (aboBoNT-A) (rehab/aboBoNT-A) vs rehabilitation alone (rehab) in post-stroke spasticity in Italy.Design: Based on both Italian National Health Ser-vice and societal perspectives, a 2-year cost-utility analysis model was performed.Subject/patients: The cost-utility analysis model considered hypothetical patients.Methods: The cost-utility analysis model was popu-lated with data concerning demographics, disease severity, healthcare and non-healthcare resource consumption. Data were collected via a questionn-aire administered to 3 highly experienced Italian physiatrists (864 out of 930 post-stroke spasticity patients on rehab/aboBoNT-A in total). Costs are ex-pressed in Euro (C) based on the year 2018.Results: The cost to society (rounded to the nearest whole C) was 022,959 (rehab/aboBoNT-A) vs 011,866 (rehab). Italian National Health Service-funded cost was (sic)7,593 (rehab/aboBoNT-A) vs C1,793 (rehab). Over a period of 2 years rehab/aboBoNT-A outperforms rehab in terms of quality-adjusted life years gained (1.620 vs 1.150). The incremental cost-utility ratio was 012,341 (Italian National Health Service viewpoint) and 023,601 (societal viewpoint). Sensitivity analyses confirmed the robustness of the baseline results.Conclusion: Despite some limitations, the higher number of quality-adjusted life years gained vs rehab and the high probability of reaching a cost-utility ratio lower than the Italian informal acceptability range (C25,000-40,000) make rehab/aboBoNT-A a cost-effective healthcare programme for treating patients with post-stroke spasticity in Italy.
AbobotulinumtoxinA and rehabilitation vs rehabilitation alone in post-stroke spasticity: A cost-utility analysis
Picelli, Alessandro;
2020-01-01
Abstract
Objective: To investigate costs and quality-adjusted life years of rehabilitation combined with abobotuli-numtoxinA (aboBoNT-A) (rehab/aboBoNT-A) vs rehabilitation alone (rehab) in post-stroke spasticity in Italy.Design: Based on both Italian National Health Ser-vice and societal perspectives, a 2-year cost-utility analysis model was performed.Subject/patients: The cost-utility analysis model considered hypothetical patients.Methods: The cost-utility analysis model was popu-lated with data concerning demographics, disease severity, healthcare and non-healthcare resource consumption. Data were collected via a questionn-aire administered to 3 highly experienced Italian physiatrists (864 out of 930 post-stroke spasticity patients on rehab/aboBoNT-A in total). Costs are ex-pressed in Euro (C) based on the year 2018.Results: The cost to society (rounded to the nearest whole C) was 022,959 (rehab/aboBoNT-A) vs 011,866 (rehab). Italian National Health Service-funded cost was (sic)7,593 (rehab/aboBoNT-A) vs C1,793 (rehab). Over a period of 2 years rehab/aboBoNT-A outperforms rehab in terms of quality-adjusted life years gained (1.620 vs 1.150). The incremental cost-utility ratio was 012,341 (Italian National Health Service viewpoint) and 023,601 (societal viewpoint). Sensitivity analyses confirmed the robustness of the baseline results.Conclusion: Despite some limitations, the higher number of quality-adjusted life years gained vs rehab and the high probability of reaching a cost-utility ratio lower than the Italian informal acceptability range (C25,000-40,000) make rehab/aboBoNT-A a cost-effective healthcare programme for treating patients with post-stroke spasticity in Italy.
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