A Systematic Review of the Cost-effectiveness of Perampanel in the Treatment of Epilepsy

Abstract

 Objective: Epilepsy is a chronic non-communicable disease that can affect all ages, genders, races, and social classes with large treatment costs that vary widely between countries and regions. Perampanel is a new generation of antiepileptic drugs (AEDs), but cost-effectiveness reports are inconsistent in several countries that have conducted pharmacoeconomic evaluations. Study with the objective of systematically summarizing the evidence on the cost-effectiveness of Perampanel for the treatment of epilepsy. Methods: An exhaustive search was performed in four publication databases. Evaluation of the reporting quality of the studies using the CHEERS checklist. Results: Findings: Costs were lower in the Perampanel group than in the Lacosamide group (Perampanel 8mg/day vs. Lacosamide 400mg/day - Total cost: $2390 (12.89%), but higher than in the antiepilepsy drugs group without perampanel (Total Direct Cost: 5475 Euro and Total Indirect Cost: -5288 Euro, Total Cost: 188 Euro) and the group with recent add-on regime such as Brivaracetam (3188 Euro in total). When compared with the Lacosamide group, the Perampanel group showed increased outcomes in all three outcomes (convulsions, LY, and QALY). Similarly, the Perampanel group showed increased outcomes in all three outcomes (convulsions, LY, and QALY) compared with groups without Perampanel. Meanwhile, QALY in the Perampanel group was lower than in the Brivaracetam group (total of 0.059 QALY). Conclusions: Perampanel as an adjunct therapy for antiepilepsy drugs may be a cost-effective treatment option in the management of epilepsy.

Keywords: Fycompa, perampanel, seizure, epilepsy, systematic review, cost-effective.

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