COMPARATIVE STUDY
JOURNAL ARTICLE

Cost-effectiveness of botulinum toxin type a in the treatment of post-stroke spasticity

Anthony Ward, Graeme Roberts, Juliet Warner, Samantha Gillard
Journal of Rehabilitation Medicine 2005, 37 (4): 252-7
16024483

OBJECTIVE: Treatment strategies for post-stroke spasticity include oral anti-spastic drugs, surgery, physiotherapy and botulinum toxin type A injection. The objective of this study was to compare the cost-effectiveness and outcomes of oral therapy vs. botulinum toxin type A treatment strategies in patients with flexed wrist/clenched fist spasticity.

METHODS: Treatment outcome and resource use data were collected from an expert panel experienced in the treatment of post-stroke spasticity. A decision tree model was developed to analyse the data.

RESULTS: Thirty-five percent of patients receiving oral therapy showed an improvement in pre-treatment functional targets which would warrant continuation of therapy, compared with 73% and 68% of patients treated with botulinum toxin type A first- and second-line therapy, respectively. Botulinum toxin type A treatment was also more cost-effective than oral therapy with the "cost-per-successfully-treated month" being 942 pounds, 1387 pounds and 1697 pounds for botulinum toxin type A first-line, botulinum toxin type A second-line and oral therapy, respectively.

CONCLUSION: In conclusion, botulinum toxin type A is a cost-effective treatment for post-stroke spasticity.

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