Published in:
01-12-2012 | Original Research Article
Cost Effectiveness of Oromucosal Cannabis-Based Medicine (Sativex®) for Spasticity in Multiple Sclerosis
Published in: PharmacoEconomics | Issue 12/2012
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Background
Spasticity is common in patients with multiple sclerosis (MS) and is a major contributor to disability. Sativex®, an oromucosal spray containing cannabis-based medicinal products, has been found to be effective in reducing spasticity symptoms.
Objective
Our objective was to estimate the cost effectiveness of Sativex® plus oral anti-spasticity medicines compared with the current standard treatment for moderate or severe spasticity in MS in the UK.
Methods
A Markov model was used to assess the costs and benefits of Sativex® plus oral anti-spasticity medicines or current standard treatment based on their effects on the quality of life of patients. The main outcome was the incremental cost-effectiveness ratio (ICER) in terms of costs per additional QALY gained over 5 years of treatment. One-way, multi-way and probabilistic sensitivity analyses were conducted to explore the impact of uncertainties on the findings.
Results
In the base case, Sativex® plus oral anti-spasticity medicines resulted in incremental costs of d7600 and a QALY gain of 0.15 per person over 5 years (ICER = £49 300 per QALY) [year 2009 data for costs]. Findings were sensitive to the costs of Sativex® (price and dose) and differences in utilities between responders and non-responders.
Conclusions
Using a willingness-to-pay threshold of £30 000 per QALY, Sativex® appears unlikely to be considered cost effective by UK funders of healthcare for spasticity in MS. This is unfortunate, since it appears that Sativex® use is likely to benefit some patients in the management of this common consequence of MS.