Cost-Effectiveness Analysis of Topiramate versus Phenobarbital in the Treatment of Children with Febrile Seizure


Abstract

Objectives: Febrile seizure is common disorder in childhood, with a prevalence of 2% to 5%. There are many drugs for treatment of this disease; however, the most common prescribed medication in Iran is phenobarbital that is cheap, but it has many side effects. We aimed to compare the cost-effectiveness of topiramate versus phenobarbital in patients with febrile seizure in the south of Iran.

Materials & methods: This econometric cost-effectiveness and cost-utility study were conducted on 91 patients with febrile seizure to assess two strategies of oral drug therapy including phenobarbital and topiramate in 2016-2017. Of all, 51 patients were treated with phenobarbital and 40 patients received topiramate. We followed up the patients for six months, using a randomized and single-blinded approach. A decision tree model was used. The outcomes of the model included febrile seizure and utility. The study was conducted from the perspective of the community; therefore, direct and indirect costs were included in the study. Excel and Tree Age software (2011) were used to analyze the results.

Results: Topiramate was cheaper and more effective than phenobarbital. In patients in the phenobarbital and topiramate groups, the mean costs were $740 and $674 per PPP, utility scores were 0.72 and 0.82, and febrile seizure without side effects were 0.3 and 0.6, respectively. Moreover, one-way sensitivity analysis confirmed the robustness of the results of the study.

Conclusion: Topiramate in patients with febrile seizure is a fully cost-effective and cost-efficient strategy suggested as a better alternative for children with febrile seizure.

Keywords: Cost-effectiveness; Cost-utility; Febrile seizure; Phenobarbital; Topiramate.

Conflict of interest statement

The authors declare that there is no conflict of interests.

Figures

Figure 1
Figure 1
Cost-Effectiveness analysis of the use of phenobarbital and topiramate for treating patients less than five years of age with febrile seizure
Figure 2
Figure 2
Cost-Utility analysis of the use of phenobarbital and topiramate for treating patients less than five years of age with febrile seizure
Figure 3
Figure 3
Tornado diagram of cost-effectiveness for patients with febrile seizure treated with phenobarbital and topiramate
Figure 4
Figure 4
Tornado diagram of cost-utility for patients with febrile seizure treated with phenobarbital and topiramate
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