Análisis de costes del uso de toxina botulínica A en España

Objective: To estimate treatment costs of blepharospasm, cervical dystonia(CD), upper limb spasticity (ULS) and spasticity in children withcerebral palsy (SCCP) with botulinum neurotoxin type A (BoNT-A) inSpain.Method: Annual BoNT-A treatment costs were calculated (2013 ex-factoryprice () applying RDL 8/2010 and RDL 9/2011 deductions), basedon initial dose (id), average dose (ad) and maximum dose (md) accordingto Summary of Product Characteristics of Botox® (100U/50U), Dysport®(500U) and Xeomin® (100U) and considering the use of complete vials.In addition, annual treatment costs were calculated considering the useof vials in more than one patient and also patient population annualtreatment costs based on diseases’ prevalence.Results: Annual BoNT-A treatment costs per patient were estimated atbetween 265 and 2,120 with savings from 10% to 55% accordingto the selected BoNT-A. CD and ULS treatment provided the greatestcost per patient. Botox® provided greater savings in ULS (id/ad), CD(id), and in blepharospasm and SCCP (id/ad/md). Dysport® treatmentwas less costly in CD (md) and ULS (md), while Xeomin® was in CD(ad). Based on the estimated treated population in Spain, the annualtreatment costs ranged from 368,392 to 13,958,836 dependingon indication, dose and BoNT-A considered.Conclusions: The appropriate BoNT-A choice would lead to considerablesavings for the National Health System. Botox® would generatelower costs per patient than other BoNT-A products in 9 out of 12 scenariosconsidered.