PND74 - COST UTILITY MODEL OF BRIVARACETAM IN THE ADJUNCTIVE TREATMENT FOR PARTIAL-ONSET EPILEPTIC SEIZURES IN SPAIN

Abstract

Brivaracetam was authorized in Spain in 2016 for treatment as adjunctive therapy for partial onset seizures with or without secondary generalization in adults over 16 years of age with epilepsy. This study aims to assess the cost effectiveness of standard antiepileptic drug therapy plus Brivaracetam compared with the third-generation anti-epileptic drugs used as standard of care from the perspective of the Spanish healthcare payer. The treatment pathway of a hypothetical cohort of patients over 2 years (8 trimesters) was simulated using a Markov model. Data about health state probabilities, seizure frequency and utility values were taken from trials or from the literature. Effectiveness measures, including the probability of changing the health status (reducing the number of seizures), and the QALYs of each health status were analysed throught studies review and real data literature. Unit costs were taken from national references and price references was 2016. Deterministic and probabilistic sensitivity analyses were conducted. Brivaracetam treatment was dominant again Eslicarbazepine and and Lacosamide, and cost-utility again Zonisamine using a willingness to pay of 20,000 Euros per quality adjusted life-year. Probabilistic Sensitive Analysis supports the result of base case. In patients with difficult-to-treat epilepsy, standard anti-epileptic drug therapy plus Brivaracetam appears to be a cost-utility option in Spain.