Cost-Effectiveness of BoNT-A Products for Treatment of Pediatric Spasticity in the United Kingdom


Danchenko N1, Johnston K2, Bolatova T2, Whalen J3
1Ipsen Global, Boulogne-Billancourt, France, 2Broadstreet Health Economics & Outcomes Research, Vancouver, BC, Canada, 3Ipsen, Slough, UK

OBJECTIVES : For children with impaired motor function, pain, or other functional difficulties attributable to focal spasticity, the UK National Institute for Health and Clinical Excellence guidelines recommend treatment with botulinum neurotoxin type A (BoNT-A). Two BoNT-A products are licensed for pediatric use in the United Kingdom: abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A), but these treatments differ in terms of doses, costs, and injection frequencies. The objective of this analysis was to evaluate the average expenditure per response obtained with aboBoNT-A or onaBoNT-A for managing pediatric spasticity of the upper (ULS) and lower (LLS) limbs.

METHODS : Cost-effectiveness analyses were conducted for BoNT-A treatment of ULS and LLS in the UK. Effectiveness was defined as response to therapy and was based on data from systematic literature reviews and meta-analyses of randomized controlled trials. BoNT-A dose was based on product label and the average weight of a pediatric (6-year-old) patient in the UK. Injection interval was based on clinical trial data, adjusted to consider differences in use observed in real-world studies of BoNT-A use in adult spasticity. Resource use for responders and non-responders was based on a survey of UK physicians treating pediatric LLS. Unit costs were informed by UK fee schedules.

RESULTS : AboBoNT-A resulted in lower annual costs compared with onaBoNT-A for the management of ULS (£487 saved) and LLS (£429 saved). Results were driven by differences in injection intervals and a higher treatment response rate for people receiving aboBoNT-A compared with onaBoNT-A. Total cost per responder was lower for people receiving aboBoNT-A compared with onaBoNT-A (ULS: £37,880 vs. £50,100; LLS: £46,459 vs. £66,037). Results were robust to sensitivity analyses.

CONCLUSIONS : AboBoNT-A may be a cost-effective choice for treatment of spasticity in children. These findings could help deliver more effective and efficient healthcare in the UK.

Conference/Value in Health Info

2021-05, ISPOR 2021, Montreal, Canada

Value in Health, Volume 24, Issue 5, S1 (May 2021)




Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis


Neurological Disorders, Pediatrics

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