TY - JOUR
T1 - The Cost-Effectiveness of Seizure Dogs for Persons Living With Severe Refractory Epilepsy
T2 - Results From the EPISODE Study
AU - van Hezik-Wester, Valérie
AU - de Groot, Saskia
AU - Kanters, Tim
AU - Wagner, Louis
AU - Ardesch, Jacqueline
AU - Brouwer, Werner
AU - Corro-Ramos, Isaac
AU - van Exel, Job
AU - Versteegh, Matthijs
N1 - Publisher Copyright: © 2024
PY - 2024/8/9
Y1 - 2024/8/9
N2 - Objectives: The Epilepsy Support Dog Evaluation study was commissioned by the Dutch Ministry of Health, Welfare and Sports to inform a reimbursement decision on seizure dogs. The randomized trial found that seizure dogs reduce seizure frequency and improve health-related quality of life of persons with severe refractory epilepsy (PSREs). This article examined the cost-effectiveness (CE) of adding seizure dogs to usual care for PSREs in The Netherlands. Methods: A microsimulation model was developed, informed by generalized linear mixed models using patient-level trial data from the Epilepsy Support Dog Evaluation study. The model adopted a 10-year time horizon and took a societal perspective. Seizure frequency was predicted as a function of time with the seizure dog. Patient utilities, caregiver utilities, and costs were predicted as a function of seizure frequency and time with the seizure dog. Results: Quality-adjusted life-years (QALYs) of PSREs with a seizure dog and usual care alone were estimated at 6.28 and 5.65, respectively (Δ 0.63). For caregivers, estimated QALYs were 6.94 and 6.52, respectively (Δ 0.42). Total costs were respectively €228 691 and €226 261 (Δ €2430). Intervention costs were largely offset by savings in informal care and healthcare. The incremental CE ratio was €2314/QALY. Probabilistic sensitivity analysis indicated a 91% probability of seizure dogs being cost-effective at the €50 000/QALY threshold. The incremental CE ratio fell well below this threshold in scenario analyses. Conclusions: Seizure dogs are likely to be a cost-effective addition to usual care for PSREs in The Netherlands.
AB - Objectives: The Epilepsy Support Dog Evaluation study was commissioned by the Dutch Ministry of Health, Welfare and Sports to inform a reimbursement decision on seizure dogs. The randomized trial found that seizure dogs reduce seizure frequency and improve health-related quality of life of persons with severe refractory epilepsy (PSREs). This article examined the cost-effectiveness (CE) of adding seizure dogs to usual care for PSREs in The Netherlands. Methods: A microsimulation model was developed, informed by generalized linear mixed models using patient-level trial data from the Epilepsy Support Dog Evaluation study. The model adopted a 10-year time horizon and took a societal perspective. Seizure frequency was predicted as a function of time with the seizure dog. Patient utilities, caregiver utilities, and costs were predicted as a function of seizure frequency and time with the seizure dog. Results: Quality-adjusted life-years (QALYs) of PSREs with a seizure dog and usual care alone were estimated at 6.28 and 5.65, respectively (Δ 0.63). For caregivers, estimated QALYs were 6.94 and 6.52, respectively (Δ 0.42). Total costs were respectively €228 691 and €226 261 (Δ €2430). Intervention costs were largely offset by savings in informal care and healthcare. The incremental CE ratio was €2314/QALY. Probabilistic sensitivity analysis indicated a 91% probability of seizure dogs being cost-effective at the €50 000/QALY threshold. The incremental CE ratio fell well below this threshold in scenario analyses. Conclusions: Seizure dogs are likely to be a cost-effective addition to usual care for PSREs in The Netherlands.
UR - http://www.scopus.com/inward/record.url?scp=85202975893&partnerID=8YFLogxK
U2 - 10.1016/j.jval.2024.07.020
DO - 10.1016/j.jval.2024.07.020
M3 - Article
C2 - 39127247
AN - SCOPUS:85202975893
SN - 1098-3015
JO - Value in Health
JF - Value in Health
ER -