Sativex® in multiple sclerosis spasticity: a cost-effectiveness model

Expert Rev Pharmacoecon Outcomes Res. 2012 Aug;12(4):439-41. doi: 10.1586/erp.12.40. Epub 2012 Jun 8.

Abstract

Background: Multiple sclerosis (MS) is a chronic, progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and a key contributor to MS-related disability.

Objectives: This study evaluated the cost-effectiveness of Sativex®, a 9-d-tetrahydrocannabinol/cannabidiol-based oromucosal spray that acts as an endocannabinoid system modulator. Sativex was recently approved for the management of resistant MS spasticity as add-on medication.

Methods: A Markov model-based analysis was performed over a 5-year horizon from a German and Spanish healthcare payer perspective. The incremental cost of Sativex was low compared with current spasticity treatments, and provided a quality-adjusted life-year gain over the current standard of care.

Results: The base-case incremental cost-effectiveness ratio for Sativex was estimated at €11,214/quality-adjusted life-year in Germany, while the drug was the dominant option in Spain, providing savings of €3496/patient over a 5-year period (year of costing: 2010). This was seen because the lower severity of spasticity in patients who had improved led to reduced resource consumption (e.g., physiotherapy and medications).

Conclusion: Despite having a relatively high acquisition cost, Sativex was shown to be a cost-effective treatment option for patients with MS-related spasticity.

Publication types

  • Comparative Study

MeSH terms

  • Cannabidiol
  • Cost-Benefit Analysis
  • Dronabinol
  • Drug Combinations
  • Drug Costs
  • Drug Resistance
  • Germany
  • Humans
  • Markov Chains
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / economics
  • Multiple Sclerosis / physiopathology
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / economics
  • Muscle Spasticity / etiology
  • Plant Extracts / economics
  • Plant Extracts / therapeutic use*
  • Quality-Adjusted Life Years
  • Severity of Illness Index
  • Spain

Substances

  • Drug Combinations
  • Plant Extracts
  • Cannabidiol
  • Dronabinol
  • nabiximols