Toxins 2012, 4(12), 1415-1426; doi:10.3390/toxins4121415
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
1
School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
2
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
3
Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
4
International Centre for Neurorehabilitation, Walkergate Park, Benfield Road, Newcastle upon Tyne NE6 4QD, UK
5
Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AA, UK
*
Author to whom correspondence should be addressed.
Received: 30 August 2012 / Revised: 12 November 2012 / Accepted: 21 November 2012 / Published: 27 November 2012
(This article belongs to the Special Issue Clinical Use of Botulinum Toxins)
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. View Full-Text
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
Scifeed alert for new publications
Never miss any articles matching your research from any publisher- Get alerts for new papers matching your research
- Find out the new papers from selected authors
- Updated daily for 49'000+ journals and 6000+ publishers
- Define your Scifeed now
Share & Cite This Article
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.