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Lee DC, Gladwell D, Hatswell AJ, et al. A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe. Health Econ Rev. 2014;4:6doi: 10.1186/s13561-014-0006-6.
Lee, D. C., Gladwell, D., Hatswell, A. J., Porter, J., Brereton, N., Tate, E., & Saunders, A. L. (2014). A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe. Health economics review, 46. https://doi.org/10.1186/s13561-014-0006-6
Lee, Dawn C, et al. "A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe." Health economics review vol. 4 (2014): 6. doi: https://doi.org/10.1186/s13561-014-0006-6
Lee DC, Gladwell D, Hatswell AJ, Porter J, Brereton N, Tate E, Saunders AL. A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe. Health Econ Rev. 2014 Apr 12;4:6. doi: 10.1186/s13561-014-0006-6. eCollection 2014. PMID: 24949280; PMCID: PMC4052771.
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Health Econ Rev. 2014 Apr 12;4:6. doi: 10.1186/s13561-014-0006-6. eCollection 2014.

A comparison of the cost-effectiveness of treatment of prolonged acute convulsive epileptic seizures in children across Europe.

Health economics review

Dawn C Lee, Daniel Gladwell, Anthony J Hatswell, Joshua Porter, Nic Brereton, Elaine Tate, Alison L Saunders

Affiliations

  1. BresMed, North Church House, 84 Queen Street, Sheffield S1 2DW, UK.
  2. BioExcel, Cornbury Park, Charlbury, Oxfordshire OX7 3EW, UK.

PMID: 24949280 PMCID: PMC4052771 DOI: 10.1186/s13561-014-0006-6

Abstract

In the majority of children and adolescents with epilepsy, optimal drug therapy adequately controls their condition. However, among the remaining patients who are still uncontrolled despite mono-, bi- or tri-therapy with chronic anti-epileptic treatment, a rescue medication is required. In Western Europe, the licensed medications available for first-line treatment of prolonged acute convulsive seizures (PACS) vary widely, and so comparators for clinical and economic evaluation are not consistent. No European guidelines currently exist for the treatment of PACS in children and adolescents and limited evidence is available for the effectiveness of treatments in the community setting. The authors present cost-effectiveness data for BUCCOLAM® (midazolam oromucosal solution) for the treatment of PACS in children and adolescents in the context of the treatment pathway in seven European countries in patients from 6 months to 18 years. For each country, the health economic model consisted of a decision tree, with decision nodes informed by clinical data and expert opinion obtained via a Delphi methodology. The events modelled are those associated with a patient experiencing a seizure in the community setting. The model assessed the likelihood of medication being administered successfully and of seizure cessation. The associated resource use was also modelled, and ambulance call-outs and hospitalisations were considered. The patient's quality of life was estimated by clinicians, who completed a five-level EuroQol five dimensions questionnaire from the perspective of a child or adolescent suffering a seizure. Despite differences in current therapy, treatment patterns and healthcare costs in all countries assessed, BUCCOLAM was shown to be cost saving and offered increased health-related benefits for patients in the treatment of PACS compared with the current local standard of care.

Keywords: BUCCOLAM; Cost–utility modelling; Epilepsy; Health technology assessment

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