APPLYING THE ACCEPTED TECHNIQUES OF INDIRECT TREATMENT COMPARISON TO MEET PAYER NEEDS FOR BRIVARACETAM VERSUS ADJUNCTIVE ANTIEPILEPTIC MEDICATIONS FOR THE TREATMENT OF FOCAL SEIZURES IN ADULT PATIENTS. DO THEY REFLECT THE NEED FOR INDIVIDUA ...
Author(s)
Charokopou M1, Harvey R2, Srivastava K3, Townsend R4, Borghs S5
1UCB Pharma, Brussels, Belgium, 2BresMed Health Solutions, Sheffield, UK, 3BresMed Health Solutions, Goa, India, 4UCB Pharma, Smyrna, GA, USA, 5UCB Pharma, Slough, UK
OBJECTIVES: Clinical practice and guidelines suggest an individualised treatment algorithm for people with epilepsy; however, despite many available treatments, 30% of patients remain uncontrolled. Indirect comparisons have failed to show differences between treatments, possibly due to reliance on registration studies conducted over several decades and the heterogeneity of epilepsy trial populations. However, in this analysis, generally accepted comparative effectiveness techniques were applied to a new market entrant, brivaracetam, thereby addressing healthcare decision-makers’ requirements. METHODS: Published randomised controlled trials comparing anti-epileptic regimens (AEDs) were collated. Brivaracetam efficacy was obtained from five clinical trials. After study selection and bias assessment, Bayesian network meta-analysis (NMA) was performed. Outcomes considered were those favoured by regulators and payers: seizure freedom, ≥50% seizure frequency reduction, rates of discontinuation and serious adverse events. RESULTS: Of the 239 publication records identified, 63 were included in the NMA analysing 13 interventions. Given the absence of significant differences between treatments, this analysis shows that no treatment is consistently better than another. Despite the identified heterogeneity, scenario analyses provided consistent results. Odds ratios (ORs) of brivaracetam versus placebo for seizure freedom and 50% seizure frequency reduction were estimated at 5.06 (95%CrI [1.46, 25.54]) and 2.58 (95%CrI [1.82, 3.71]), respectively. Brivaracetam had the lowest risk of discontinuation (OR: 1.84, 95%CrI [0.88, 4.06]) and serious adverse events (OR: 0.73, 95% CrI [0.31, 1.65])
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PRM12
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
Neurological Disorders
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