A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis.
Severity of spasticity in multiple sclerosis (MS) directly correlates with the level and cost of care required. This study assessed whether a tetrahydrocannabinolcannabidiol (THCCBD) oromucosal spray for treatment of moderate-severe MS spasticity is a cost-effective use of healthcare resources in Wales. A Markov model was developed to compare THCCBD plus standard of care (SoC) treatments with SoC alone. At 30 years, total incremental cost for THCCBD plus SoC treatment was estimated at £3,836patient (ICER £10,891quality-adjusted life year QALY). Hospital admission costs had the greatest effect on the base case ICER. Inclusion of carer cost led to incremental cost of -£33,609patient (ICER -£95,423QALY). The THCCBD spray was found to be cost-effective for the treatment of spasticity in MS, and dominant, if home carer costs were included. Use of THCCBD has the potential to generate cost savings by significantly improving the symptoms of moderate to severe MS spasticity.