Nemati Hamid, Talebianpour Hamid, Lotfi Farhad, Sepehri Nazanin Zahra, Keshavarz Khosro
Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Health Care Management, School of Management and Medical Information, Shiraz University of Medical Science, Shiraz, Iran.
Iran J Child Neurol. 2019 Fall;13(4):109-120.
Febrile seizure is common disorder in childhood, with a prevalence of 2% to 5%. There are many drugs for treatment of this disease; however, the most common prescribed medication in Iran is phenobarbital that is cheap, but it has many side effects. We aimed to compare the cost-effectiveness of topiramate versus phenobarbital in patients with febrile seizure in the south of Iran.
MATERIALS & METHODS: This econometric cost-effectiveness and cost-utility study were conducted on 91 patients with febrile seizure to assess two strategies of oral drug therapy including phenobarbital and topiramate in 2016-2017. Of all, 51 patients were treated with phenobarbital and 40 patients received topiramate. We followed up the patients for six months, using a randomized and single-blinded approach. A decision tree model was used. The outcomes of the model included febrile seizure and utility. The study was conducted from the perspective of the community; therefore, direct and indirect costs were included in the study. Excel and Tree Age software (2011) were used to analyze the results.
Topiramate was cheaper and more effective than phenobarbital. In patients in the phenobarbital and topiramate groups, the mean costs were $740 and $674 per PPP, utility scores were 0.72 and 0.82, and febrile seizure without side effects were 0.3 and 0.6, respectively. Moreover, one-way sensitivity analysis confirmed the robustness of the results of the study.
Topiramate in patients with febrile seizure is a fully cost-effective and cost-efficient strategy suggested as a better alternative for children with febrile seizure.
热性惊厥是儿童期常见疾病，患病率为2%至5%。治疗该疾病的药物众多；然而，伊朗最常用的处方药是苯巴比妥，它价格便宜，但有许多副作用。我们旨在比较托吡酯与苯巴比妥在伊朗南部热性惊厥患者中的成本效益。
这项计量经济学成本效益和成本效用研究于2016 - 2017年对91例热性惊厥患者进行，以评估两种口服药物治疗策略，包括苯巴比妥和托吡酯。其中，51例患者接受苯巴比妥治疗，40例患者接受托吡酯治疗。我们采用随机单盲方法对患者进行了六个月的随访。使用了决策树模型。该模型的结果包括热性惊厥和效用。该研究从社区角度进行；因此，研究中纳入了直接和间接成本。使用Excel和Tree Age软件（2011）分析结果。
托吡酯比苯巴比妥更便宜且更有效。在苯巴比妥组和托吡酯组患者中，按购买力平价计算的平均成本分别为740美元和674美元，效用评分分别为0.72和0.82，无副作用的热性惊厥发生率分别为0.3和0.6。此外，单向敏感性分析证实了该研究结果的稳健性。
托吡酯治疗热性惊厥患者是一种完全具有成本效益且高效的策略，被建议作为热性惊厥儿童的更好替代方案。
