Abstracts

Rationale: The objective of this study was to estimate the incremental Budget Impact (BI) of utilizing perampanel to treat primary generalized tonic clonic seizures (PGTC) patients in addition to existing partial-onset seizures (POS) in patients who are 12 years of age and older in the US.Methods: The incremental budget impact of adopting perampanel for PGTC indication in addition to an existing POS indication was estimated by comparing the cost of POS seizures (with perampanel) and cost of PGTC and POS seizures (with perampanel). Costs included drugs, healthcare provider visits, emergency room visits, hospitalizations (direct) and overall work impairment (indirect). The model was developed from a societal perspective with a time horizon of five years.Results: An estimated 210,370 patients who are at least 12 years old are treated for refractory epilepsy in the US each year, among them, 40.2% and 59.8% are refractory PGTC and POS, respectively, requiring adjunctive therapy. The market share uptake of perampanel for POS indication from year 1 to year 5 was 0.35%, 0.73%, 1.28%, 1.73%, and 2.06%, respectively. The uptake of perampanel was projected to increase with the addition of PGTC indication to 0.40%, 1.01%, 1.83%, 2.53%, and 3.04%, respectively. During the first five years, the adoption of perampanel for PGTC in addition to the existing POS indication is projected to decrease overall costs by $0.18M, $0.91M, $1.82M, $2.65M and $3.28M, respectively. The cumulative savings from perampanel adoption for the first five years is projected to be $8.83M. Adoption of perampanel was cost saving, as the increase in drug costs ($29.94M) was offset by the lower utilization of direct medical resources (-$15.21M) and lower overall work impairment (-$23.57M). The PMPM was $0.0079 for drug costs only and -$0.0023 for all direct and indirect costs.Conclusions: With potential cost savings of 8.83 million dollars over a period of five years and demonstrated efficacy in seizure control in refractory patients, perampanel should be considered a valuable treatment in patients refractory to prior antiepileptic treatments.