Sativex® in multiple sclerosis spasticity a cost-effectiveness model.
Multiple sclerosis (MS) is a chronic, progressive disease that carries a high socioeconomic burden. Spasticity (rigidity and spasms) is common in MS and a key contributor to MS-related disability. This study evaluated the cost-effectiveness of Sativex®, a 9-d-tetrahydrocannabinolcannabidiol-based oromucosal spray that acts as an endocannabinoid system modulator. Sativex was recently approved for the management of resistant MS spasticity as add-on medication. A Markov model-based analysis was performed over a 5-year horizon from a German and Spanish healthcare payer perspective. The incremental cost of Sativex was low compared with current spasticity treatments, and provided a quality-adjusted life-year gain over the current standard of care. The base-case incremental cost-effectiveness ratio for Sativex was estimated at €11,214quality-adjusted life-year in Germany, while the drug was the dominant option in Spain, providing savings of €3496patient over a 5-year period (year of costing 2010). This was seen because the lower severity of spasticity in patients who had improved led to reduced resource consumption (e.g., physiotherapy and medications). Despite having a relatively high acquisition cost, Sativex was shown to be a cost-effective treatment option for patients with MS-related spasticity.