OBJECTIVES

Botulinum toxins are commonly used treatments for cervical dystonia (CD). Clinical trials have demonstrated their efficacy, but data from real-life clinical practice as well as comparative data on the cost and outcome of different botulinum toxin products are limited. This study was an economic evaluation from a French cost perspective of abobotulinumtoxinA (aboBoNT-A) vs onabotulinumtoxinA (onaBoNT-A) using data from an international, prospective, observational study (NCT00833196).

METHODS

This analysis included 356 adults with idiopathic CD treated with aboBoNT-A (n=253) or onaBoNT-A (n=103) from 38 centres across Europe and Australia.

Costs considered were drug costs only, and the main clinical outcome measure was quality of life, measured as change in health utility from baseline to end of study visit. Both outcomes were adjusted for relevant covariates. Utility was mapped from the TWSTRS total scale, using a previous publication (Jen, J Med Econ. 2014;17(11):803-9). Response rate was a secondary clinical outcome measure.

RESULTS

The mean changes in health utility adjusted for covariates, were 0.021 (95% CI: 0.017-0.024) and 0.011 (95% CI: 0.006 – 0.017) for aboBoNT-A and onaBoNT-A, respectively (p=0.005), i.e. a difference of 0.009 (95%CI: 0.003 – 0.016). Response rates were numerically or statistically significantly higher for aboBoNT-A depending on response definition assessed. Mean treatment costs for aboBoNT-A and onaBoNT-A were 314.1 (95%CI: 299.1 - 329.0) and 346.6 (95%CI: 322.9 - 370.4) euros, respectively. Treatment with aboBoNT-A therefore dominated onaBoNT-A in this economic analysis, i.e. led to both lower cost and improved clinical outcome.

CONCLUSIONS

This comparative analysis demonstrated that treatment with aboBoNT-A may be less costly and lead to improved clinical outcomes when compared with onaBoNT-A, from a French healthcare perspective. Additional comparative clinical data from larger patient cohorts, as well as more information about cost consequences of an improvement in clinical outcome would be of value to further confirm these findings.