Abstracts

Rationale: The objective of this study was to evaluate the cost-effectiveness of rufinamide relative to topiramate and lamotrigine as adjunctive treatment for children with Lennox-Gastaut Syndrome (LGS). Methods: A Markov state transition model was developed with 4 health states WC75, WC50, NC (corresponding to >=75%, >=50% and <75%, and <50% reduction in tonic-atonic (drop attack) seizure frequency respectively) and “death”. Efficacy and safety data were obtained from the literature. In the absence of head-to-head clinical studies, indirect/mixed treatment comparisons were used to obtain efficacy and safety estimates. LGS related health state utilities were obtained from a separate study which was carried out among the UK general public and caregivers/parents. Treatment benefits, as reflected with percent of patients achieving a given degree of reduction of drop-attack seizure frequency over a three-year time horizon, were translated to quality adjusted life years (QALYs). Medical resource and cost data were obtained from expert panel survey and published UK sources. Future costs and benefits were discounted by 3.5%. Uncertainty in the source data was translated into uncertainty in cost-effectiveness estimates by means of probabilistic sensitivity analysis. Alternative scenario analyses were also performed.