caa a22 4500 445807784 CHVBK 20180317145202.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00415-011-5998-9 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5998-9 Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study [Elektronische Daten] [Pierre Burbaud, Camille Ducerf, Emmanuelle Cugy, Jean-Louis Dubos, François Muller, Dominique Guehl, Patrick Dehail, Didier Cugy, Nicholas Moore, Alain Lagueny, Pierre-Alain Joseph] Botulinum toxin (BTA) is a safe and effective therapeutic tool for many neurological conditions but few studies have investigated its real cost in neurological practice. We evaluated the daily cost of botulinum toxin type A (BTA) treatment through a cost effectiveness analysis alongside a prospective study of BTA injections at a French University Hospital over a 2-year follow-up period. The data of 3,108 BTA injections performed in 870 adult patients presenting with dystonia, facial hemispasm, or spasticity were entered in the database. Patients were questioned at each visit about the subjective effectiveness of the previous injection. The daily cost of BTA treatment was calculated as the ratio of each session's cost (including all additional costs) to the duration of subjective efficacy. The subjective rating of efficacy duration was 17.3±7.7weeks for facial hemispasm, 15.4±7.7 for blepharospasm, 14.3±6.7 for cervical dystonia, 14.5±7.8 and 14.1±7.4weeks for upper and lower limb spasticity, respectively. The daily cost of BTA injections was 0.57±0.20€ for facial hemispasm, 0.95±0.30€ for blepharospasm, 2.85±0.86€ for cervical dystonia, 3.38±1.49€ and 3.62±1.81€ for upper and lower limb spasticity, respectively. When associated costs were considered, the daily cost of BTA injections was clearly increased (45-93%) in limb spasticity or rigidity but remained only modestly increased (15-37%) in other indications. These results obtained in a large cohort of patients show that BTA treatment has a low daily cost for a long-lasting effect, with a daily cost/benefit ratio that greatly depends on the indications. Springer-Verlag, 2011 Botulinum toxin nationallicence Dystonia nationallicence Spasticity nationallicence Cost effectiveness study nationallicence Burbaud Pierre Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Ducerf Camille Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Cugy Emmanuelle Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Dubos Jean-Louis Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Muller François Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Guehl Dominique Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Dehail Patrick Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Cugy Didier Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Moore Nicholas Department of Clinical Pharmacology, Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Lagueny Alain Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Joseph Pierre-Alain Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut Journal of Neurology Springer-Verlag 258/9(2011-09-01), 1670-1675 0340-5354 258:9<1670 2011 258 415 https://doi.org/10.1007/s00415-011-5998-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5998-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Burbaud Pierre Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Ducerf Camille Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Cugy Emmanuelle Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Dubos Jean-Louis Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Muller François Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Guehl Dominique Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Dehail Patrick Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Cugy Didier Department of Clinical Neurophysiology, Centre Hospitalier Pellegrin, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Moore Nicholas Department of Clinical Pharmacology, Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Lagueny Alain Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Joseph Pierre-Alain Department of Physical Medicine and Rehabilitation (EA4136), Centre Hospitalier Universitaire de Bordeaux, Université Bordeaux 2, Place Amélie-Rabat-Léon, 33076, Bordeaux, France aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/9(2011-09-01), 1670-1675 0340-5354 258:9<1670 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer