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 £7600 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.
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 £7600 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.
Authors: A Novotna; J Mares; S Ratcliffe; I Novakova; M Vachova; O Zapletalova; C Gasperini; C Pozzilli; L Cefaro; G Comi; P Rossi; Z Ambler; Z Stelmasiak; A Erdmann; X Montalban; A Klimek; P Davies Journal: Eur J Neurol Date: 2011-03-01 Impact factor: 6.089
Authors: N Hyman; M Barnes; B Bhakta; A Cozens; M Bakheit; B Kreczy-Kleedorfer; W Poewe; J Wissel; P Bain; S Glickman; A Sayer; A Richardson; C Dott Journal: J Neurol Neurosurg Psychiatry Date: 2000-06 Impact factor: 10.154
Authors: C Collin; E Ehler; G Waberzinek; Z Alsindi; P Davies; K Powell; W Notcutt; C O'Leary; S Ratcliffe; I Nováková; O Zapletalova; J Piková; Z Ambler Journal: Neurol Res Date: 2010-03-19 Impact factor: 2.448
Authors: J C Hobart; A Riazi; A J Thompson; I M Styles; W Ingram; P J Vickery; M Warner; P J Fox; J P Zajicek Journal: Brain Date: 2005-11-09 Impact factor: 13.501
Authors: Samuel Herzog; Marian Shanahan; Peter Grimison; Anh Tran; Nicole Wong; Nicholas Lintzeris; John Simes; Martin Stockler; Rachael L Morton Journal: Pharmacoeconomics Date: 2018-01 Impact factor: 4.981