A pharmacoeconomic comparison of monotherapy with Tegretol, Finlepsin and Trileptal (preliminary data)

Pharmacoeconomics comprises a system of relatively new methods that inform policy makers about the costs and benefits of different therapies so that limited health care resources may be allocated efficiently. The purpose of this study was to perform a pharmacoeconomic comparison of three of the most widely used antiepileptic drugs in Bulgaria: carbamazepine (two different products: Tegretol and Finlepsin) and oxcarbazepine (Trileptal).

The inclusion criteria for entering the study were: women or men of age with newly detected and clinically diagnosed epilepsy,monotherapy treatment with the studied drugs, ability to keep personal records. The follow-up visits were conducted in three-month periods, each visit including a thorough evaluation of effectiveness, costs and quality of life. Effectiveness was assessed as seizure reduction percentage and time till new seizure. Costs included direct and indirect medical and nonmedical costs, related to epilepsy or its treatment. The quality of life of the patient was assessed with Quality of Life in Epilepsy Inventory 31 (QOLIE)--an evaluation instrument accepted for use in clinical practice. The statistical methods used included: descriptive analysis, Pearson correlation and Kaplan-Meyer analyses.

The mean seizure reduction was 86.05% for Finlepsin, 83.31% for Tegretol and 66.67% for Trileptal. There were no seizure-free patients on Trileptal, while almost 60% of Tegretol and nearly 50% in Finlepsin patients remained seizure-free for a period of one year.

The quality of life of all patients was high, indicating good efficacy and safety as assessed by patients. There was a significant difference in terms of costs in the Trileptal group compared with the other two groups --it incurred higher annual costs as well as higher cost-per-QALY value.