Economic Evaluation of CBD-enriched Drug in Pediatric Drug-resistant Epilepsy
DOI:
https://doi.org/10.14456/jdms.2023.31Keywords:
Pediatric drug-resistant epilepsy, CBD-enriched, Cost-effectiveness analysisAbstract
Background: Drug-resistant epilepsy means a failure to stop seizures in spite of taking antiepileptic drugs of more than 2 types. It is found in about 30% of epileptic patients. Although there is evidence suggesting that cannabisbased products are effective in reducing seizures in pediatric drug-resistant epilepsy, the cost-effectiveness is not clear. Objective: To perform an economic evaluation of CBD-enriched drugs in pediatric drug-resistant epilepsy. Methods: A cost-utility analysis was conducted by using the Markov model based on a societal perspective. The model was developed to compare costs and quality-adjusted life years (QALYs) between the adjunctive treatment with CBD-enriched drugs and the regular treatment in pediatric drug-resistant epilepsy. Cost data were collected from the Neurological Institute of Thailand whereas the probability of clinical response and utility using the data from literature. The incremental cost-effectiveness ratio (ICER) was presented in the value of the year 2020. The uncertainty of parameters was explored via a one-way sensitivity and probabilistic sensitivity analysis. Results: The total cost and QALYs of the CBD-enriched group VS the regular group were 3,178,112 THB VS 3,027,659 THB and 21.88 VS 21.07 years respectively. ICER was 187,108 THB/QALY. The one-way sensitivity analysis showed that the 3 most sensitive factors were the relative risk of status epilepticus, the probability of seizure relapse, and the relative risk of seizure-free of CBD to standard therapy. We further analyzed by calculating the proper cost of CBD to reach the willing to pay threshold at160,000 THB and found that the lower price of CBD-enriched of 1,630 THB/1000mg (14.2% price reduction) will be cost-effective for pediatric drug-resistant epilepsy. It would also decrease the country’s budget. Conclusion: The CBD-enriched drug is not cost-effective for pediatric drug-resistant epilepsy, but it can be improved by lowering the price by 14.2%.
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