Category: Spasticity
Objective: The objective of this study was to evaluate the impact of different brands of botulinum neurotoxin type A (BoNT-A) on OOP patient spending based on price and time between injections.
Background: BoNT-A is efficacious and well tolerated for the treatment of adults with upper limb spasticity. Patients suffering from limb spasticity require long-term treatment, which, due to OOP payments, can be financially burdensome. Information in this analysis came from the Upper Limb International Spasticity (ULIS)-III study (NCT02454803), which is a longitudinal, prospective, observational cohort study that aimed to describe real-life clinical practice and assess patient-centered goal attainment with integrated upper limb spasticity management.
Method: The cost to patients was evaluated based on the assumption of 20% OOP cost sharing of patients, without a deductible, and a 3-year time horizon. The time to retreatment and the mean dose for three different brands of BoNT-A (abobotulinumtoxinA [aboBoNT-A], onabotulinumtoxinA [onaBoNT-A], and incobotulinumtoxinA [incoBoNT-A]) were obtained from interim analysis of ULIS-III Cycle 1 data, with the mean (95% confidence interval) time to reinjection being 186.1 days (177.5; 194.8), 148.0 days (134.2; 161.9), and 148.7 days (131.4; 166.0) for the three brands, respectively, and mean doses of 828.3U, 235.3U, and 275.1U, respectively. Drug costs were obtained from the IBM Micromedex Red Book. Other costs included administration costs, derived from the Physician Fee Schedule Search (2016).
Results: The results showed substantial differences in OOP cost burden to patients. The OOP cost per injection was $340 for aboBoNT-A, $339 for onaBoNT-A, and $318 for incoBoNT-A. By considering the time intervals between injections, the annual OOP costs were $666, $833, and $777 respectively, which over the 3 years of the analysis amount to total OOP costs of $1,997, $2,498, and $2,332, respectively, for the three comparators.
Conclusion: Although aboBoNT-A was slightly more expensive from a per-injection perspective, the increased time to reinjection reported in the study resulted in aboBoNT-A being the least expensive of the therapies over the 3-year study period. These results indicate a significant economic benefit in terms of OOP costs for patients who administered aboBoNT-A as treatment for upper limb spasticity. This abstract was previously presented at ISPRM-AAP, March 8, 2020.
To cite this abstract in AMA style:
L. Turner-Stokes, A. Lysandropoulos, S. Wietek, C. Divers. Evaluating patient out-of-pocket (OOP) expenses using real world utilization data of botulinum toxins [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/evaluating-patient-out-of-pocket-oop-expenses-using-real-world-utilization-data-of-botulinum-toxins/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-patient-out-of-pocket-oop-expenses-using-real-world-utilization-data-of-botulinum-toxins/