COST-EFFECTIVENESS OF CENOBAMATE FOR FOCAL SEIZURES IN DRUG RESISTANT EPILEPSY IN JORDAN
Author(s)
Rawan Alfroukh, MSc1, Farah Radaydeh, MSc1, Nimer Alkhatib, PhD2.
1Path economics,LLC, Amman, Jordan, 2College of pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
1Path economics,LLC, Amman, Jordan, 2College of pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
OBJECTIVES: To assess the cost-effectiveness of cenobamate (CENO) versus available adjunctive antiseizure medications in Jordan from clinical and economic perspectives
METHODS: A cost-utility analysis was conducted from the perspective of the Jordanian payer to evaluate CENO compared with brivaracetam (BRIV), eslicarbazepine acetate (ESLI), lacosamide (LACO), and perampanel (PERA) in adults with focal-onset seizures who failed ≥2 prior antiseizure medications. A cohort-based Markov model with four health states (seizure-free, ≥50% response, no response, and discontinuation) was developed based on Martinez et al and populated with clinical inputs from a network meta-analysis by Laskier et al. The model used 3-month cycles over a 2-year time horizon. Transition probabilities, adverse events, and utilities were derived from published sources and validated against Li et al. Costs were obtained from local Jordanian sources and expressed in Jordanian dinar (JOD). Outcomes were reported as incremental cost-utility ratios (ICURs). Deterministic and probabilistic sensitivity analyses were performed.
RESULTS: CENO generated higher quality-adjusted life years (QALYs) and lower costs compared with all comparators (BRIV, ESLI, LACO, and PERA). Compared with BRIV, CENO generated savings of −JOD 31,147 per QALY gained; −JOD 7,836 versus ESLI; −JOD 10,950 versus LACO; and −JOD 9,564 versus PERA. Probabilistic sensitivity analysis confirmed the robustness of these findings.
CONCLUSIONS: CENO is a dominant (cost-saving and more effective) adjunctive treatment for focal-onset seizures in Jordan. These findings support its potential value for reimbursement and inclusion in the national formulary.
METHODS: A cost-utility analysis was conducted from the perspective of the Jordanian payer to evaluate CENO compared with brivaracetam (BRIV), eslicarbazepine acetate (ESLI), lacosamide (LACO), and perampanel (PERA) in adults with focal-onset seizures who failed ≥2 prior antiseizure medications. A cohort-based Markov model with four health states (seizure-free, ≥50% response, no response, and discontinuation) was developed based on Martinez et al and populated with clinical inputs from a network meta-analysis by Laskier et al. The model used 3-month cycles over a 2-year time horizon. Transition probabilities, adverse events, and utilities were derived from published sources and validated against Li et al. Costs were obtained from local Jordanian sources and expressed in Jordanian dinar (JOD). Outcomes were reported as incremental cost-utility ratios (ICURs). Deterministic and probabilistic sensitivity analyses were performed.
RESULTS: CENO generated higher quality-adjusted life years (QALYs) and lower costs compared with all comparators (BRIV, ESLI, LACO, and PERA). Compared with BRIV, CENO generated savings of −JOD 31,147 per QALY gained; −JOD 7,836 versus ESLI; −JOD 10,950 versus LACO; and −JOD 9,564 versus PERA. Probabilistic sensitivity analysis confirmed the robustness of these findings.
CONCLUSIONS: CENO is a dominant (cost-saving and more effective) adjunctive treatment for focal-onset seizures in Jordan. These findings support its potential value for reimbursement and inclusion in the national formulary.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE205
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas