Pharmacoeconomic evaluation of brivaracetam versus perampanel as add-on therapy for drug-resistant focal epilepsy
- VernacularTitle:布立西坦对比吡仑帕奈用于耐药性局灶性癫痫添加治疗的药物经济学评价
- Author:
Jiale QIAO
1
;
Fanqi LIU
1
;
Yuchen TANG
2
;
Jie CHENG
3
;
Yan SHI
2
;
Jun QI
2
;
Zhiqiang DONG
2
Author Information
1. School of Pharmacy，Baotou Medical College，Inner Mongolia University of Science & Technology，Inner Mongolia Baotou 014040，China;Dept. of Pharmaceutical Clinical Research，The First Affiliated Hospital of Baotou Medical College，Inner Mongolia University of Science & Technology，Inner Mongolia Baotou 014040，China
2. Dept. of Pharmaceutical Clinical Research，The First Affiliated Hospital of Baotou Medical College，Inner Mongolia University of Science & Technology，Inner Mongolia Baotou 014040，China
3. Dept. of Pharmaceutical Clinical Research，The First Affiliated Hospital of Baotou Medical College，Inner Mongolia University of Science & Technology，Inner Mongolia Baotou 014040，China;School of Pharmacy，Yantai University，Shandong Yantai 264000，China
- Publication Type:Journal Article
- Keywords:
brivaracetam;
perampanel;
drug-resistant focal epilepsy;
Pharmacoeconomic evaluation;
Markov model;
Cost-effectiveness analysis
- From:
China Pharmacy
2026;37(18):2382-2388
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the cost-effectiveness of brivaracetam （BRV） versus perampanel （PER） as add-on therapy for drug-resistant focal epilepsy in adults from the perspective of the Chinese healthcare system.METHODS A Markov model was established to simulate the progression of drug-resistant focal epilepsy in adults， with a simulation cycle of 5 months， a time horizon of 44 years， and a discount rate of 4.5%. Clinical data required for the model were derived from the phase Ⅲ clinical trial of BRV and a post hoc analysis of PER； cost data and utility data were obtained from Yaozh and related literature. The willingness-to-pay （WTP） threshold was set at twice China’s 2025 per capita gross domestic product （GDP） [199 330 yuan per quality-adjusted life year （QALY）]， and a cost-effectiveness analysis was adopted to compare the cost-effectiveness of the regimens. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to confirm the stability of the base-case analysis conclusions.RESULTS The incremental cost-effectiveness ratio （ICER） of BRV 50 mg/d as an add-on therapy versus PER 8 mg/d was 44 823.08 yuan/QALY， which was below the WTP threshold； the ICER of BRV 200 mg/d versus PER 12 mg/d was 238 783.00 yuan/QALY， which was above the WTP threshold. In the one-way sensitivity analysis， the direct medical cost of seizures ≥53 times/year and the health utility value of a seizure-free state per year had a relatively large impact on the two ICER results mentioned above， respectively. Probabilistic sensitivity analysis indicated that the above results were robust.CONCLUSIONS For the selection of add-on therapy for drug-resistant focal epilepsy in adults in China， when twice China’s per capita GDP is used as the WTP threshold， BRV 50 mg/d has a cost-effectiveness advantage over PER 8 mg/d， whereas BRV 200 mg/d not have a cost-effectiveness advantage over PER 12 mg/d.
