CLINICAL AND ECONOMIC EVALUATION OF LACOSAMIDE IN PATIENTS WITH PARTIAL EPILEPSY

• Published in: Farmakoèkonomika (Moskva. Online) Vol. 9; no. 3; pp. 38 - 47
• Main Authors: Pyadushkina, E. A., Frolov, M. Yu
• Format: Journal Article
• Language: English
• Published: IRBIS LLC 01-12-2016
• Subjects: antiepileptic drugs; budget impact analysis; lacosamide; partial epilepsy
• ISSN: 2070-4909; 2070-4933
• DOI: 10.17749/2070-4909.2016.9.3.038-047

Aims of study: 1) development of a model for forecasting of impact of Lacosamide administration for antiseizure therapy of local convulsions in patients, who are resistant to previous antiseizure therapy, for the account of healthcare and social security budget of the constituent members of the Russian Federation; 2) assessment of clinical and economical feasibility of Lacosamide administration from the point of view of healthcare and social security budget of the constituent members of the Russian Federation, by example of Kaliningrad region.Materials and methods. General model of Microsoft Excel was developed for analysis of impact of Lacosamide administration to healthcare and social security budget of the constituent members of the Russian Federation in three scenarios: Lacosamide as concomitant drug to standard therapy in comparison with standard therapy without Lacosamide (scenario 1), Lacosamide in comparison with Perampanel, both as concomitant drug to standard therapy (scenario 2) and early administration of Lacosamide as the first concomitant drug to standard monotherapy in comparison with its late administration (scenario 3). The Model allows calculation of the direct medical costs (for the drugs and medical services) and direct non-medical costs (payment of temporary and permanent disability allowances) from the point of view of healthcare and social security system of a constituent member of the Russian Federation. The simulation uses the results of clinical studies and meta-analyses of the antiseizure drugs under consideration, data of state statistical monitoring, and results of previous epilepsy burden analysis conducted in the Russian Federation. The costs in model are calculated on the basis of registered prices on drugs from the List of vital and essential medicines (VEM), price of public purchases of drugs and regulations of financial costs per unit of medical aid in Russia in 2015. We conducted the analysis of impact of Lacosamide administration to the budget of the constituent member of the Russian Federation by example of Kaliningrad region.Results. Scenario 1: in case of increase of total costs by 6.75%; 10.42% and 17.38% in the first, second and third year respectively, administration of Lacosamide as concomitant drug, in comparison with standard therapy without Lacosamide, allows to obtain additional therapy response in 4, 6, 11 patients and remission in 1, 1 and 2 patients, who are resistant to the previous antiseizure therapy. Scenario 2: Taking into consideration the commeasurable efficacy and safety, the economic advantages of Lacosamide over Perampanel are 1.64, 2.65, 4.74 million rubles in the first, second and third year respectively. Scenario 3: administration of Lacosamide as the first concomitant drug after the failed monotherapy allows reaching of the increased therapy response rate and remissions number in comparison with Lacosamide administration as the second concomitant drug and reduce the budget expenses for antiseizure therapy by 11.45 and 1.85 million rubles in the first and the second year respectively.