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Economic Evaluation of Cannabinoid Oil for Dravet Syndrome: A Cost-Utility Analysis

Author

Listed:
  • Jesse Elliott

    (University of Ottawa
    University of Ottawa Heart Institute)

  • Bláthnaid McCoy

    (University of Toronto
    The Hospital for Sick Children Toronto)

  • Tammy Clifford

    (University of Ottawa)

  • Beth K. Potter

    (University of Ottawa)

  • George A. Wells

    (University of Ottawa
    University of Ottawa Heart Institute)

  • Doug Coyle

    (University of Ottawa)

Abstract

Introduction Cannabinoid oils are being increasingly used to treat Dravet syndrome, yet the long-term costs and outcomes of this approach are unknown. Thus, we examined the cost effectiveness of cannabinoid oil as an adjunctive treatment (added to clobazam and valproate), compared with adjunctive stiripentol or with clobazam and valproate alone, for the treatment of Dravet syndrome in children. Methods We performed a probabilistic cost-utility analysis from the perspective of the Canadian public health care system, comparing cannabinoid oil and stiripentol (both on a background of clobazam and valproate) with clobazam and valproate alone. Costs and quality-adjusted life-years (QALYs) were estimated using a Markov model that followed a cohort of children aged from 5 to 18 years through model states related to seizure frequency. Model inputs were obtained from the literature. The cost effectiveness of adjunctive cannabinoid oil, adjunctive stiripentol, and clobazam/valproate alone was assessed through sequential analysis. The influence of perspective and other assumptions were explored in scenario analyses. All costs are expressed in 2019 Canadian dollars, and costs and QALYs were discounted at a rate of 1.5% per year. Results The incremental cost per QALY gained with the use of adjunctive cannabinoid oil, from the health care system perspective, was $32,399 compared with clobazam and valproate. Stiripentol was dominated by cannabinoid oil, producing fewer QALYs at higher costs. At a willingness-to-pay threshold of $50,000, cannabinoid oil was the optimal treatment in 76% of replications. From a societal perspective, cannabinoid oil dominated stiripentol and clobazam/valproate. The interpretation of the results was insensitive to model and input assumptions. Conclusion Compared with clobazam/valproate, adjunctive cannabinoid oil may be a cost-effective treatment for Dravet syndrome, if a decision maker is willing to pay at least $32,399 for each QALY gained. The opportunity costs of continuing to fund stiripentol, but not cannabinoid oil, should be considered.

Suggested Citation

  • Jesse Elliott & Bláthnaid McCoy & Tammy Clifford & Beth K. Potter & George A. Wells & Doug Coyle, 2020. "Economic Evaluation of Cannabinoid Oil for Dravet Syndrome: A Cost-Utility Analysis," PharmacoEconomics, Springer, vol. 38(9), pages 971-980, September.
  • Handle: RePEc:spr:pharme:v:38:y:2020:i:9:d:10.1007_s40273-020-00923-5
    DOI: 10.1007/s40273-020-00923-5
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 14th September 2020
      by Rita Faria in The Academic Health Economists' Blog on 2020-09-14 11:00:07

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