Booth-Clibborn N, Best L, Stein K; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 87.

UK South and West Development and Evaluation Service, Wessex Institute for Health Research and Development, University of Southampton, United Kingdom.

BACKGROUND: Motor neurone disease (MND) is a progressive degenerative disease with a life expectancy of between 3 and 5 years. The incidence of MND in the UK is about 2.2 per 100,000 adults. Riluzole is a new drug for a condition which has no existing therapy. Since the launch of the drug in 1996 there has been uncertainty in the UK about the benefits and relative costs. PURPOSE: To estimate the cost-effectiveness of riluzole therapy using UK costs and the trial evidence in patients with amyotrophic lateral sclerosis variants of MND (over 90% of MND patients). METHOD: Information sources were systematically searched and the pharmaceutical company and licensing agency were contacting for unpublished studies. The UK MND Association was consulted. RESULTS: Three 18 month double-blind randomized placebo-controlled trials were found (one unpublished). Death or tracheostomy and functional status were outcomes. In early stage patients the evidence suggested that the absolute risk of being alive or without tracheostomy was 56.8% for the riluzole group compared with 50.4% for the placebo group. After adjustment, the relative risk was 0.65(95% CI 0.5-0.85). We calculated the number needed to treat (NNT) to delay one death or tracheostomy at 18 months (based on adjusted data) was 6 (95% CI 4-13). There was no improvement of functional status, and quality of life data was not available. The cost of treating 6 patients for 18 months was Pounds 33,500, an amount which may delay one death or tracheostomy at 18 months. Patients continue to require paliative care when treated with riluzole. CONCLUSIONS: MND places an enormous burden on patients and carers. No significant functional benefits were found with riluzole therapy. The finding of the delay in death or tracheostomy at 18 months was limited as the extension and quality of life after this time was not known. There was therefore insufficient evidence to make a judgement on cost-effectiveness.

Publication Types:

• Meeting Abstracts

Keywords:

• Adult
• Amyotrophic Lateral Sclerosis
• Clinical Trials as Topic
• Cost-Benefit Analysis
• Double-Blind Method
• Humans
• Motor Neuron Disease
• Multicenter Study
• Randomized Controlled Trials as Topic
• Riluzole
• Tracheostomy
• economics
• surgery
• hsrmtgs

Other ID:

• HTX/99600383

UI: 102237061

From Meeting Abstracts