Abstract
Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY) gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER) of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made.
| Original language | English |
|---|---|
| Pages (from-to) | 1415-26 |
| Number of pages | 12 |
| Journal | Toxins |
| Volume | 4 |
| Issue number | 12 |
| Early online date | 27 Nov 2012 |
| DOIs | |
| Publication status | Published - Dec 2012 |
Keywords
- botulinum toxins type A/administration & dosage
- combined modality therapy
- cost-benefit analysis
- upper limb spasticity
- muscle spasticity/economics
- physical therapy modalities
- quality-adjusted life years
- stroke/complications
- upper extremity
- cost-effectiveness
Documents and Links
- Shackley, P. et al (2012) Cost-effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A: results from the botulinum toxin for the upper limb after stroke (BoTULS) trial
© 2012 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).