Cost effectiveness of sativex

Epub: Slof  & Gras. Sativex(®) in multiple sclerosis spasticity: a cost-effectiveness model. Expert Rev Pharmacoecon Outcomes Res. 2012 Jun 8.


Background: 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-δ-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/MSer over a 5-year period (year of costing: 2010). This was seen because the lower severity of spasticity in MSers 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 MSers with MS-related spasticity.

"Interesting data; I wonder what the health economists at NICE would say about this model and data. As you may know already we are having major problems accessing Sativex in the UK for MSers under our care. The bottom line with Sativex is that it is not a drug for everyone; only about 40-50% of MSers respond and even then some can't tolerate the drug because of side effects. Have any of you responded to the drug?"

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