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Economic Evaluation of the InTENSE Program of Therapy Alongside Botulinum Neurotoxin a for the Rehabilitation of Chronic Upper Limb Spasticity
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Economic Evaluation of the InTENSE Program of Therapy Alongside Botulinum Neurotoxin a for the Rehabilitation of Chronic Upper Limb Spasticity
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Economic Evaluation of the InTENSE Program of Therapy Alongside Botulinum Neurotoxin a for the Rehabilitation of Chronic Upper Limb Spasticity
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Journal Article
Economic Evaluation of the InTENSE Program of Therapy Alongside Botulinum Neurotoxin a for the Rehabilitation of Chronic Upper Limb Spasticity
2025
Overview
Spasticity is a persistent and debilitating consequence of stroke and effective rehabilitation is a healthcare priority. Botulinum neurotoxin A (BoNT-A) with supportive therapy has increasingly been embedded within clinical practice for treatment of post-stroke spasticity. But the evidence for this approach has hitherto been limited to the findings of a limited number of small trials. The InTENSE trial was undertaken specifically to provide high-quality clinical trial evidence focusing on the effect of BoNT-A and adjunctive therapy on upper limb spasticity. While the clinical trial did not detect a significant impact upon clinical outcomes, there remains a need to evaluate any impact on the broader use of healthcare resources and overall cost-effectiveness. A detailed cost–utility analysis of the InTENSE trial was undertaken. The costs over the 12-month follow-up period were compared with quality-adjusted life years (QALY) gained using utilities generated from the EQ-5D three level (EQ-5D-3L) instrument. There were no significant differences in QALY gained between the intervention and control groups identified, or in the majority of health and community care costs. The Incremental Cost-Effectiveness Ratio per QALY gained was estimated at AU $63,947.11 (Australian dollars), which is well above accepted thresholds for cost-effectiveness in Australia. The study was unable to identify evidence for the cost-effectiveness of treatment approaches combining BoNT-A with adjunctive therapy.
Publisher
MDPI AG,MDPI
Subject
/ Botulinum Toxins, Type A - economics
/ Botulinum Toxins, Type A - therapeutic use
/ Female
/ Humans
/ Male
/ Muscle Spasticity - drug therapy
/ Muscle Spasticity - economics
/ Muscle Spasticity - etiology
/ Muscle Spasticity - rehabilitation
/ Neuromuscular Agents - economics
/ Neuromuscular Agents - therapeutic use
/ Stroke
/ Therapy
/ Toxins
