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PND32 COST-EFECTIVENESS AND BUDGET IMPACT OF VAGUS NERVE STIMULATION WITH ASPIRE SR MODEL 106 COMPARED TO ANTI-EPILEPTIC DRUGS IN A SUBGROUP OF PATIENTS WITH DRUG RESISTANT EPILEPSY IN PUBLIC SETTING IN TURKEY

      Objectives

      Epilepsy accounts for 0.6% of the global disease burden according to the World Health Organization. Around 30% of patients have drug resistant epilepsy (DRE) and continue to have seizures despite being prescribed anti-epileptic drugs (AED). Vagus Nerve Stimulation (VNS) therapy has become an important treatment option for DRE. The aim of this study is to understand the cost-effectiveness (CE) and budget impact (BI) of VNS with AspireSR Model 106 in a subgroup of DRE patients in Turkey.

      Methods

      A Markov based CE and BI were conducted from the public payer perspective. Unit Costs and frequency of health utilisation in DRE were retrieved from Social Security Institution (SGK) lists and a literature review, including drugs, medical devices, adverse reactions and hospitalisations. For the CE, clinical outcomes have been extrapolated over 10 years based on outcomes identified through a systematic review and meta-analysis. In the BI, the number of eligible patients of a DRE subgroup expected to benefit the most, was estimated based on epidemiological data and historical VNS market penetration rates. The time horizon for the BI was 3 years.

      Results

      Costs and quality-adjusted life-years (QALYs) were estimated at 1,699,303.74TRY and 6.29 for VNS arm and 2,196,469.83TRY and 5.71 for AED, respectively (hence, VNS therapy dominates). In the BI; 48, 117, 206 patients were estimated to receive the implant over consecutive years, resulting in cumulative savings of 604,374TRY over 3 years.

      Conclusions

      VNS Therapy has become important for DRE patients resulting in disease control and higher QALYs. The study shows that Aspire SR Model 106 results in lower costs and higher QALYs in a subgroup of DRE patients when compared to AED.