Servicio de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, Spain; Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Madrid, Spain.
Departamento de Medicina Física y Rehabilitación, Universidad Rey Juan Carlos, Madrid, Spain; Servicio de Rehabilitación y Medicina Física del Hospital Universitario de Fuenlabrada, Fuenlabrada (Madrid), Spain.
Neurologia (Engl Ed). 2022 Oct;37(8):653-660. doi: 10.1016/j.nrleng.2019.10.011. Epub 2021 Nov 19.
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 Abobotulinumtoxin 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.
肉毒毒素 A 是治疗局部痉挛的一线治疗药物。然而，这种治疗方法的经济影响尚不完全清楚。本研究旨在描述痉挛诊所中康复服务治疗成人痉挛患者使用肉毒毒素 A 的实际成本，为期一年。
我们回顾性地审查了 2017 年期间进行的所有医疗程序。我们收集了使用的毒素类型（利鲁唑毒素 A、肉毒毒素 A 或阿巴毒素 A）、注射的单位数、解剖区域以及渗透之间的时间间隔的数据。还计算了药物和间接成本（如人员和耗材）的成本。
这是第一项描述西班牙成年痉挛患者肉毒毒素治疗实际成本的研究。2017 年，164 名患者进行了 510 次渗透治疗。我们服务中治疗痉挛的总成本为 116789.70 欧元。每位患者的年平均治疗成本分别为肉毒毒素 A 603.64 欧元、阿巴毒素 A 642.69 欧元和利鲁唑毒素 A 707.59 欧元。
我们对真实临床实践的经济研究与文献中发表的理论模型一致。每种毒素的不同特征以及无法在每种药物的单位之间建立等效性，阻止了我们直接比较这些成本。
