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Toxins 2012, 4(12), 1415-1426; doi:10.3390/toxins4121415
Article

Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial

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Received: 30 August 2012; in revised form: 12 November 2012 / Accepted: 21 November 2012 / Published: 27 November 2012
(This article belongs to the Special Issue Clinical Use of Botulinum Toxins)
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Abstract: Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY) gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER) of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made.
Keywords: botulinum toxin type A; stroke; upper limb spasticity; cost-effectiveness botulinum toxin type A; stroke; upper limb spasticity; cost-effectiveness
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Shackley, P.; Shaw, L.; Price, C.; Wijck, F.V.; Barnes, M.; Graham, L.; Ford, G.A.; Steen, N.; Rodgers, H. Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial. Toxins 2012, 4, 1415-1426.

AMA Style

Shackley P, Shaw L, Price C, Wijck FV, Barnes M, Graham L, Ford GA, Steen N, Rodgers H. Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial. Toxins. 2012; 4(12):1415-1426.

Chicago/Turabian Style

Shackley, Phil; Shaw, Lisa; Price, Christopher; Wijck, Frederike V.; Barnes, Michael; Graham, Laura; Ford, Gary A.; Steen, Nick; Rodgers, Helen. 2012. "Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial." Toxins 4, no. 12: 1415-1426.



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