Cost-effectiveness of botulinum toxin type a in the treatment of post-stroke spasticity.

Abstract

OBJECTIVE:

Treatment strategies for post-stroke spasticity include oral anti-spastic drugs, surgery, physiotherapy and botulinum toxin type A injection. The objective of this study was to compare the cost-effectiveness and outcomes of oral therapy vs. botulinum toxin type A treatment strategies in patients with flexed wrist/clenched fist spasticity.

METHODS:

Treatment outcome and resource use data were collected from an expert panel experienced in the treatment of post-stroke spasticity. A decision tree model was developed to analyse the data.

RESULTS:

Thirty-five percent of patients receiving oral therapy showed an improvement in pre-treatment functional targets which would warrant continuation of therapy, compared with 73% and 68% of patients treated with botulinum toxin type A first- and second-line therapy, respectively. Botulinum toxin type A treatment was also more cost-effective than oral therapy with the "cost-per-successfully-treated month" being 942 pounds, 1387 pounds and 1697 pounds for botulinum toxin type A first-line, botulinum toxin type A second-line and oral therapy, respectively.

CONCLUSION:

In conclusion, botulinum toxin type A is a cost-effective treatment for post-stroke spasticity.

• Authors: Anthony Ward, Graeme Roberts, Juliet Warner, Samantha Gillard
• Journal: Journal of rehabilitation medicine (J Rehabil Med) Vol. 37 Issue 4 Pg. 252-7 (Jul 2005) ISSN: 1650-1977 [Print] Sweden
• PMID: 16024483 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Muscle Relaxants, Central
• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Administration, Oral
• Botulinum Toxins, Type A (administration & dosage, economics)
• Cost-Benefit Analysis
• Health Care Costs
• Humans
• Injections, Intramuscular
• Models, Economic
• Muscle Relaxants, Central (administration & dosage, economics)
• Muscle Spasticity (drug therapy, economics, etiology, rehabilitation)
• Neuromuscular Agents (administration & dosage, economics)
• Stroke (complications, economics, physiopathology)
• Stroke Rehabilitation
• Surveys and Questionnaires
• Treatment Outcome