Влияние на бюджет добавления перампанела к терапии больных эпилепсией в возрасте 12 лет и старше при парциальных приступах с вторичной генерализацией и без нее и при первично-генерализованных тонико-клонических приступах в условиях Российской Федерации

Objectives. To assess the incremental budget impact (BI) of using of utilizing perampanel to treat partial-onset seizures (POS) and primary generalized tonic-clonic seizures (PGTCS) in patients who are 12 years of age and older in Russia.Methods. The budget impact was estimated by comparing two different scenarios: Cost of POS & PGTCS without Perampanel and Cost of POS & PGTCS with Perampanel (Perampanel Adoption). In the latter scenario, market share of perampanel was assumed to increase every year for up to five years. The model was developed from a payer perspective with a time horizon of five years. Direct costs included drugs and medical resources (hospitalization, emergency care costs, visits to physician). BI was calculated as the difference in costs between Perampanel Adoption scenario and the cost without Perampanel.Results. In Russia, approximately 125,499 patients who are at least 12 years old are treated for refractory POS & PGTCS each year. The market share of perampanel in the perampanel adoption scenario from year 1 to year 5 was 0.1%, 0.5%, 1.0%, 2.0% and 3.0%, respectively. During the same period, the adoption of perampanel is projected to increase drug costs (in millions) by RUB15.2 (1.2%), RUB76.1 (6.2%), RUB152.4 (12.3%), RUB305.4 (24.7%), and RUB459.0 (37.0%), respectively. A significant portion of the 5-year cumulative increase in drug costs (RUB 1,008 million) will be offset by a decrease in non-drug medical resources (-RUB152.7 million). The cumulative budget impact from perampanel adoption for the first five years is projected to be RUB855 million (0.7%), with an additional 231 patients gaining seizure freedom over a period of 5 years from the adoption of perampanel.Conclusion. Perampanel should be considered as an alternative alongside current antiepileptic drugs in patients with symptoms refractory to prior antiepileptic treatments.Цель — оценить влияние на бюджет (ВБ) использования перампанела для лечения парциальных приступов (partial onset seizures — POS) c генерализацией и без, и первично-генерализованных тонико-клонических приступов (primary generalized tonic-clonic seizures — PGTC) у пациентов с эпилепсией старше 12 лет в Российской Федерации.Материалы и методы. Оценка ВБ проводилась по двум сценариям: стоимость лечения POS и PGTCs без перампанела и стоимость лечения POS и PGTCs с перампанелом. В последнем сценарии предполагалось, что доля перампанела в рынке повышалась каждый год с горизонтом в пять лет. Прямые оплаты включали стоимость медикаментов и медицинских ресурсов (госпитализаций, услуг скорой помощи, посещений врача). ВБ рассчитывалось как разница стоимости между добавлением перампанела и сценарием без перампанела.Результаты. Каждый год в России примерно 125 499 пациентов старше 12 лет получают лечение по поводу рефрактерных POS и PGTC. Доля перампанела в рынке при сценарии с его добавлением с первого до пятого года составила 0,1%; 0,5%; 1%; 2% и 3% соответственно. За этот же период при добавлении перампанела предполагалось повышение стоимости лекарств (в млн руб.) на 15,2 (1,2%); 76,1 (6,2%); 152,4 (12,3%); 305,4 (24,7%) и 459,0 (37%) соответственно. Значимая часть пятилетнего суммарного повышения стоимости лекарств, составившая 1 008 млн руб., нивелируется снижением затрат на нелекарственные медицинские ресурсы (–152,7 млн руб.). Прогнозируется, что суммарное ВБ при добавлении перампанела в первые пять лет составит 855 млн руб. (0,7%), при этом еще у 231 пациента будет до- стигнуто отсутствие приступов в течение пять лет после добавления перампанела.Заключение. Перампанел может рассматриваться в качестве альтернативного адъювантного средства среди других противоэпилептических препаратов при резистентности к проводимой противоэпилептической терапии

BUDGET IMPACT ANALYSIS OF PERAMPANEL FOR ADJUNCTIVE TREATMENT IN EPILEPSY PATIENTS 12 YEARS OF AGE AND OLDER FOR PARTIAL ONSET SEIZURES WITH OR WITHOUT SECONDARY GENERALIZATION AND PRIMARY GENERALIZED TONIC-CLONIC SEIZURES IN THE RUSSIAN FEDERATION

Objectives. To assess the incremental budget impact (BI) of using of utilizing perampanel to treat partial-onset seizures (POS) and primary generalized tonic-clonic seizures (PGTCS) in patients who are 12 years of age and older in Russia.Methods. The budget impact was estimated by comparing two different scenarios: Cost of POS & PGTCS without Perampanel and Cost of POS & PGTCS with Perampanel (Perampanel Adoption). In the latter scenario, market share of perampanel was assumed to increase every year for up to five years. The model was developed from a payer perspective with a time horizon of five years. Direct costs included drugs and medical resources (hospitalization, emergency care costs, visits to physician). BI was calculated as the difference in costs between Perampanel Adoption scenario and the cost without Perampanel.Results. In Russia, approximately 125,499 patients who are at least 12 years old are treated for refractory POS & PGTCS each year. The market share of perampanel in the perampanel adoption scenario from year 1 to year 5 was 0.1%, 0.5%, 1.0%, 2.0% and 3.0%, respectively. During the same period, the adoption of perampanel is projected to increase drug costs (in millions) by RUB15.2 (1.2%), RUB76.1 (6.2%), RUB152.4 (12.3%), RUB305.4 (24.7%), and RUB459.0 (37.0%), respectively. A significant portion of the 5-year cumulative increase in drug costs (RUB 1,008 million) will be offset by a decrease in non-drug medical resources (-RUB152.7 million). The cumulative budget impact from perampanel adoption for the first five years is projected to be RUB855 million (0.7%), with an additional 231 patients gaining seizure freedom over a period of 5 years from the adoption of perampanel.Conclusion. Perampanel should be considered as an alternative alongside current antiepileptic drugs in patients with symptoms refractory to prior antiepileptic treatments