Cost-effectiveness analysis of antiepileptic drugs in the treatment of Lennox–Gastaut syndrome

Abstract

An economic model evaluated the costs and outcomes of adjunctive clobazam therapy for Lennox–Gastaut syndrome (LGS) compared with adjunctive lamotrigine, rufinamide, and topiramate. Clinical data were used to estimate baseline frequency and the percentage of drop-seizure reductions over 3months (all comparators) and 2years (rufinamide). Claims data from a large US health care plan were employed to estimate costs. After 3months, 21.5% of those receiving clobazam were drop-seizure–free. Over a 3-month horizon, clobazam was more effective and less expensive than comparators, with the assumption that >0.77% of drop seizures required medical care. Below this threshold, topiramate was less costly than clobazam. With the base-case assumption that 2.3% of drop seizures were medically attended, costs for patients receiving clobazam totaled $30,147 versus $34,223–$35,378 for comparators. Clobazam was more efficacious and less costly than rufinamide over a 2-year horizon. The percentage of medically attended drop seizures was a driver of results. Clobazam treatment may be cost-saving.