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| Scenario | Difference in annual cost between severe and moderate spasticity (EUR) | Required responder rate* for cost balance |
|---|
| Base case scenarioa | ~ 45,000 | 4% |
| Excl. indirect costs | ~ 39,000 | 4% |
| Association between spasticity and costsb |
| - 75% | 33,750 | 5% |
| - 50% | 22,500 | 8% |
| - 25% | 11,250 | 15% |
| Required responder rate* for cost effectiveness# |
| QALY weights according to Doan et al. [11] | 36% |
| QALY weights according to Svensson et al. [5] | 14% |
- aBase case scenario; 34% of hospital BoNT-A use for spasticity, cost per BoNT-A treatment session = 574 EUR, full causal (100%) relationship between change of spasticity severity grade and associated cost (45,000 EUR)
- bEffects of decreased influence on the costs (45,000 EUR, see Method section) associated with transition between severity grades of spasticity
- *In accordance with the study by Doan et al., treatment responders were defined as patients transitioning to a lower level of disability (severe to moderate), as defined by the Disability Assessment Scale (DAS) [11]
- #based on a Willingness To Pay of ~ 52,000 EUR (corresponding to 500,000 SEK at the mean exchange rate for 2017; 1 SEK = 9.6 EUR), and assuming transition of responders at first injection and subsequent stability for at least a year
