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Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain

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A Correction to this article was published on 20 February 2018

This article has been updated

Abstract

Background and Objective

More than 30% of patients with epilepsy have inadequate control of seizures with drug therapy. The goal of this study is to determine the budget impact (BI) of the introduction of brivaracetam to the portfolio of approved drugs in Spain as adjunctive therapy for the treatment of partial-onset epilepsy in patients over 16 years old with a 5-year time horizon in the Valencia Community, a Spanish region with a population of 5 million.

Methods

The BI model compares the pharmaceutical expenditure on antiepileptics in two scenarios: with and without brivaracetam. It assumes that the introduction and increased use of brivaracetam will lead to a proportional decrease in consumption of coexisting adjunctive antiepileptics and calculates the evolution of the consumption of brivaracetam over 5 years (2016–2020). The model was designed from the perspective of the Spanish National Health System. Data on the candidate population, consumption of antiepileptics, market share and pharmaceutical expenditure were obtained from real-world data. Finally, a sensitivity analysis was carried out on the set of variables involved in the evolution of costs using a Monte-Carlo simulation.

Results

The model estimates that the target population eligible for adjunctive antiepileptics will hold at around 2352 between 2016 and 2020. Annual expenditure on antiepileptics is approximately €3.6 million. The number of patients eligible for treatment with brivaracetam would increase from 42 to 179 and annual savings of 0.09–0.37% would be created, representing €41,873 over 5 years (0.23% of the total budget). The sensitivity analysis corroborates that the probability of achieving savings with brivaracetam is around 84%.

Conclusions

Brivaracetam is a therapeutic alternative that allows savings for the health system in patients with non-controlled epilepsy in monotherapy, having a fixed, predictable annual cost (independent of dose) from the first day of treatment as the lack of need for titration means the patient is within a range of therapeutic doses from the first dose.

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Acknowledgements

The opinions expressed in this paper are those of the authors and do not necessary reflect those of the afore-named. Any errors are the authors’ responsibility. We would also like to thank John Wright for the English editing.

Funding

This work was supported partially by the Instituto de Salud Carlos III-Ministerio de Economía y Competitividad and the European Union (FEDER [Fonds Européen de Développement Économique et Régional (European Fund for Economic and Regional Development)] funds)—FIS PI12/00037.

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Authors and Affiliations

  1. Departament of Economics and Social Sciences. Research Centre for Health Economics and Management, INECO, Universitat Politècnica de València, Edificio 7 J, Camino de Vera s/n, 46022, Valencia, Spain

    Isabel Barrachina-Martínez & David Vivas-Consuelo

  2. Department of Neurology, Hospital Clínico Universitario de Valencia, Valencia, Spain

    Anna Piera-Balbastre

Authors
  1. Isabel Barrachina-Martínez
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  2. David Vivas-Consuelo
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  3. Anna Piera-Balbastre
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Corresponding author

Correspondence to Isabel Barrachina-Martínez.

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Conflict of interest

David Vivas Consuelo has received a grant from UCB Pharma. Isabel Barrachina Martínez and Anna Piera Balbastre have no conflicts of interest to declare.

Additional information

The text under the abstract, Conclusion was incorrectly published in the original publication. This is now updated in the original article.

A correction to this article is available online at https://doi.org/10.1007/s40261-018-0630-8.

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Barrachina-Martínez, I., Vivas-Consuelo, D. & Piera-Balbastre, A. Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain. Clin Drug Investig 38, 353–363 (2018). https://doi.org/10.1007/s40261-017-0615-z

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