Lifetime cost-utility analysis of patients with refractory epilepsy treated with adjunctive topiramate therapy - Cost-effectiveness in refractory epilepsy

Objective: To evaluate the cost-effectiveness profile of topiramate as adjunctive treatment in patients with refractory epilepsy. Study design: Lifetime cost-utility analysis based on a pharmacoeconomic model. Methods: Effectiveness data (seizure frequency reduction) were derived from the most recent placebo-controlled clinical trial, whilst quality of life and cost data were retrieved from the published literature. Our pharmacoeconomic model was based on a patient-level approach that incorporated the clinical data of the randomised, controlled trial. Main outcome measures and results: Our analysis showed that chronic topiramate treatment costs pound21 353 per quality-adjusted life year (QALY) gained (incremental lifetime cost of pound1 024 941 and incremental utility of 48 QALYs, for every 100 patients) [discounted values with a yearly rate of 3%] (year of costing 2001). Sensitivity analyses suggested a range from pound19 915 to pound24 518 per QALY gained. Conclusions: Our results showed that adjunctive topiramate therapy has a favourable pharmacoeconomic profile in patients with refractory epilepsy.