A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis

Expert Rev Pharmacoecon Outcomes Res. 2016 Dec;16(6):771-779. doi: 10.1586/14737167.2016.1140574. Epub 2016 Feb 26.

Abstract

Background: Severity of spasticity in multiple sclerosis (MS) directly correlates with the level and cost of care required. This study assessed whether a tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray for treatment of moderate-severe MS spasticity is a cost-effective use of healthcare resources in Wales.

Methods: A Markov model was developed to compare THC/CBD plus standard of care (SoC) treatments with SoC alone.

Results: At 30 years, total incremental cost for THC/CBD plus SoC treatment was estimated at £3,836/patient (ICER: £10,891/quality-adjusted life year [QALY]). Hospital admission costs had the greatest effect on the base case ICER. Inclusion of carer cost led to incremental cost of -£33,609/patient (ICER: -£95,423/QALY).

Conclusions: The THC/CBD spray was found to be cost-effective for the treatment of spasticity in MS, and dominant, if home carer costs were included. Use of THC/CBD has the potential to generate cost savings by significantly improving the symptoms of moderate to severe MS spasticity.

Keywords: Multiple sclerosis; pharmacoeconomics; resource utilization; spasticity; tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray; treatment costs.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cannabidiol / administration & dosage*
  • Cannabidiol / economics
  • Cost Savings
  • Cost-Benefit Analysis
  • Dronabinol / administration & dosage*
  • Dronabinol / economics
  • Hospitalization / economics
  • Humans
  • Markov Chains
  • Models, Economic
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / economics
  • Multiple Sclerosis / physiopathology
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Quality-Adjusted Life Years
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Wales

Substances

  • Cannabidiol
  • Dronabinol