Objective: The aim was to carry out a cost-utility analysis for IncobotulinumtoxinA (INCO) administered with flexible treatment intervals compared to onabotulinumtoxinA (ONA) administered with fixed intervals for the management of cervical dystonia (CD) and blepharospasm (BEB) from the payer perspective in four major Canadian provinces.
Background: INCO and ONA have marketing authorization in Canada, among others, for the treatment of CD and BEB. INCO is the only botulinum toxin in Canada with marketing authorization for administration at flexible intervals between 6-20 weeks based on the patients’ individual clinical needs. Prospective comparison trials have demonstrated that INCO and ONA result in comparable safety and efficacy when a 1:1 clinical conversion ratio is used.
Method: A Markov state transition model was developed to estimate costs (CDN$, 2019) and benefits (Quality Adjusted Life Years, QALY) of the management of CD and BEB with INCO administered at flexible intervals (6 to 20 weeks) vs ONA administered at fixed interval (12 weeks); a 5-year horizon time was used. It was assumed that patients experience a re-emergence of symptoms after toxin treatment effect wanes. Utilities were extracted from a published study in patients with focal dystonia. Costs were based on Canadian public databases.
Results: For all provinces studied and for both indications, INCO was a dominant strategy vs. ONA, with higher effectiveness and lower cost. Patients treated with INCO flexible intervals had less symptomatic weeks, while receiving comparable numbers of injection sessions.
Conclusion: The treatment of CD and BEB with INCO at flexible intervals determined by the patients’ individual clinical needs is an efficient therapeutic alternative compared to the administration of ONA in four major Canadian markets.
To cite this abstract in AMA style:M.E Gendron, R. Kazerooni, D. Vézina. Cost-Utility Analysis of Flexible Intervals with IncobotulinumtoxinA Versus Fixed Dosing with OnabotulinumtoxinA in the Management of Cervical Dystonia and Blepharospasm in Major Canadian Markets [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/cost-utility-analysis-of-flexible-intervals-with-incobotulinumtoxina-versus-fixed-dosing-with-onabotulinumtoxina-in-the-management-of-cervical-dystonia-and-blepharospasm-in-major-canadian-markets/. Accessed November 28, 2023.
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