Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, O&N 2 P.O. Box 521, Herestraat 49, 3000 Leuven, Belgium.
Expert Rev Pharmacoecon Outcomes Res. 2010 Jun;10(3):309-15. doi: 10.1586/erp.10.18.
Epileptic seizures are associated with significant morbidity, impaired quality of life, mortality and substantial healthcare costs. Treatment with anti-epileptic drugs is the mainstay of therapy, with pharmacotherapy aiming to achieve seizure freedom or seizure reduction. Given that approximately 30% of patients are not controlled with monotherapy regimens, adjunctive therapy with multiple anti-epileptic drugs can be envisaged. This article aims to review economic evaluations of anti-epileptic drugs as adjunctive therapy for refractory epilepsy in adult patients. Studies were included if they examined the costs and consequences of different pharmacotherapeutic adjunctive therapies for refractory epilepsy. Uncertainty surrounds the cost-effectiveness of anti-epileptic drugs as adjunctive therapy for refractory epilepsy owing to methodological limitations and design differences between studies. Although cost-effectiveness estimates vary between studies, adjunctive therapy of refractory epilepsy appears to be cost effective, depending on the cost-effectiveness threshold used by pricing/reimbursement agencies. However, there is a need for more, better-designed and comprehensive economic evaluations of adjunctive therapy for refractory epilepsy with anti-epileptic drugs.
癫痫发作与显著的发病率、生活质量受损、死亡率和大量的医疗保健费用有关。抗癫痫药物治疗是治疗的主要方法，旨在实现无癫痫发作或减少癫痫发作。鉴于大约 30%的患者不能通过单一疗法控制，因此可以考虑使用多种抗癫痫药物的辅助治疗。本文旨在综述抗癫痫药物作为成人难治性癫痫辅助治疗的经济学评价。如果研究考察了不同药物治疗辅助治疗难治性癫痫的成本和后果，则将其纳入研究。由于方法学限制和研究之间的设计差异，抗癫痫药物作为难治性癫痫辅助治疗的成本效益存在不确定性。尽管成本效益估计在研究之间有所不同，但根据定价/报销机构使用的成本效益阈值，难治性癫痫的辅助治疗似乎具有成本效益。然而，需要对难治性癫痫的抗癫痫药物辅助治疗进行更多、设计更好和更全面的经济评价。
