Department of Pharmacoeconomics and Social Pharmacy, Karol Marcinkowski University of Medical Sciences in Poznań, 60-865 Poznan, Poland.
Department of Developmental Neurology, Karol Marcinkowski University of Medical Sciences in Poznań, 60-355 Poznan, Poland.
Int J Environ Res Public Health. 2022 Jun 20;19(12):7517. doi: 10.3390/ijerph19127517.
This study assessed the differentiation of treatment costs with newer and older antiepileptic drugs (AEDs) through its correlation with treatment effectiveness and an adverse event (AE) in pediatric patients with epilepsy (PPE).
PPE on monotherapy of AEDs for the last 6 months were screened for this study. Seizure frequency during the study was compared with that within 6 months before the study. The following parameters were also assessed: quality of life in epilepsy, Pittsburgh Sleep Quality Index, and Liverpool AEs Profile. An incremental cost-effectiveness ratio (ICER) analysis based on the costs of pharmacotherapy was also performed.
Out of 80 PPE, 67 completed the study, and 13 PPE were lost after failing to meet the inclusion criteria. A total of 56.71% of PPE were on newer AEDs, and 43.28% were on older AEDs. Newer and older AEDs did not differ significantly in seizure frequency reduction and quality of life parameters, although these were improved significantly during the study period. As per ICER, newer AEDs need an additional EUR 36.82 per unit reduction in seizure frequency.
Newer AEDs have comparatively better efficacy, although not significantly better than older AEDs. However, the additional cost per unit improvement is quite high with newer AEDs, necessitating pharmacoeconomic consideration in pediatric epilepsy treatment.
本研究通过评估治疗效果和不良事件(AE)与新型和旧型抗癫痫药物(AED)的相关性,评估儿科癫痫患者(PPE)的治疗成本差异。
对过去 6 个月接受 AED 单药治疗的 PPE 进行了筛选。研究期间的癫痫发作频率与研究前 6 个月内的频率进行了比较。还评估了以下参数:癫痫生活质量、匹兹堡睡眠质量指数和利物浦 AE 概况。还基于药物治疗成本进行了增量成本效益比(ICER)分析。
在 80 名 PPE 中,有 67 名完成了研究,有 13 名 PPE 在未能符合纳入标准后失访。共有 56.71%的 PPE 使用新型 AED,43.28%使用旧型 AED。新型和旧型 AED 在减少癫痫发作频率和生活质量参数方面没有显著差异,尽管在研究期间这些参数都有显著改善。根据 ICER,新型 AED 每单位减少癫痫发作频率需要额外的 36.82 欧元。
新型 AED 的疗效较好,虽然不比旧型 AED 好,但新型 AED 每单位改善的额外成本相当高,这在儿科癫痫治疗中需要进行药物经济学考虑。