Hernández Herrero D, Miangolarra Page J C
Servicio de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, España; Escuela internacional de doctorado, Universidad Rey Juan Carlos, Madrid, España.
Departamento de Medicina Física y Rehabilitación, Universidad Rey Juan Carlos, Madrid, España; Servicio de Rehabilitación y Medicina Física del Hospital Universitario de Fuenlabrada, Fuenlabrada (Madrid), España.
Neurologia (Engl Ed). 2022 Oct;37(8):653-660. doi: 10.1016/j.nrl.2019.10.006. Epub 2019 Dec 30.
Botulinum toxin A is the first-line treatment for localised spasticity. However, the economic impact of this treatment is not fully known. This study aimed to describe the real costs of botulinum toxin A for the treatment of adult patients with spasticity at a spasticity clinic pertaining to a rehabilitation service, over a period of one year.
We retrospectively reviewed all medical procedures carried out during the year 2017. We collected data on the type of toxin used (incobotulinumtoxin A, onabotulinumtoxin A, or AAbobotulinumtoxin A), the number of units injected, the anatomical region, and the time elapsed between infiltrations. The costs of medication and indirect costs, such as staff and consumables, were also calculated.
This is the first study to describe the real costs of botulinum toxin treatment of spasticity in adult patients in Spain. In 2017, 510 infiltration procedures were performed in 164 patients. The total cost of treating spasticity in our service was €116 789.70. The mean annual cost per patient was €603.64 for onabotulinumtoxin A, €642.69 for abobotulinumtoxin A, and €707.59 for incobotulinumtoxin A.
Our economic study of real clinical practice is consistent with the theoretical models published in the literature. The different characteristics of each toxin and the inability to establish an equivalence between the units of each drug prevents us from directly comparing these costs.
A型肉毒毒素是局部痉挛的一线治疗方法。然而，这种治疗方法的经济影响尚不完全清楚。本研究旨在描述在一家隶属于康复服务机构的痉挛诊所，使用A型肉毒毒素治疗成年痉挛患者一年期间的实际费用。
我们回顾性分析了2017年期间进行的所有医疗程序。我们收集了所用毒素类型（incobotulinumtoxin A、onabotulinumtoxin A或AAbotulinumtoxin A）、注射单位数量、解剖部位以及两次注射之间的时间间隔等数据。还计算了药物成本以及人员和耗材等间接成本。
这是第一项描述西班牙成年患者肉毒毒素治疗痉挛实际费用的研究。2017年，164例患者共进行了510次注射程序。我们服务中治疗痉挛的总成本为116789.70欧元。onabotulinumtoxin A每位患者的年均成本为603.64欧元，abobotulinumtoxin A为642.69欧元，incobotulinumtoxin A为707.59欧元。
我们对实际临床实践的经济学研究与文献中发表的理论模型一致。每种毒素的不同特性以及无法确定每种药物单位之间的等效性，使我们无法直接比较这些成本。
