dc.creator | Falip, Mercè | es |
dc.creator | López González, Francisco Javier | es |
dc.creator | Martín Herranz, Isabel | es |
dc.creator | Merino Bohórquez, Vicente | es |
dc.creator | Montoya, Javier | es |
dc.creator | Rey Gómez-Serranillos, Isabel | es |
dc.creator | Rodriguez Uranga, Juan Jesús | es |
dc.creator | Ruiz, Elías | es |
dc.creator | Sancho López, Aranzazu | es |
dc.creator | Trillo Mata, Jose Luis | es |
dc.creator | Gil, Alicia | es |
dc.date.accessioned | 2024-07-31T16:14:29Z | |
dc.date.available | 2024-07-31T16:14:29Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Falip, M., López González, F.J., Martín Herranz, I., Merino Bohórquez, V., Montoya, J., Rey Gómez-Serranillos, I.,...,Gil, A. (2023). Value Contribution of Cenobamate for the Treatment of Focal-Onset Seizures (FOS) in Patients with Drug-resistant Epilepsy (DRE) in Spain through Reflective Multi-Criteria Decision Analysis (MCDA). Epilepsy and Behavior, 145, 109350. https://doi.org/10.1016/j.yebeh.2023.109350. | |
dc.identifier.issn | 1525-5069 | es |
dc.identifier.issn | 1525-5050 | es |
dc.identifier.uri | https://hdl.handle.net/11441/161809 | |
dc.description.abstract | Introduction: Epilepsy is one of the most common neurological conditions worldwide. The main goal of
its treatment is to achieve seizure freedom without intolerable adverse effects. However, despite the
availability of many anti-seizure medications, including the latest options, called third-generation anti-
seizure medications (ASMs), approximately 40% of people with epilepsy present drug-resistant epilepsy
(DRE). Cenobamate is the first ASM approved in Spain for the adjunctive treatment of Focal-Onset
Seizures (FOS) in adult patients with DRE. In a chronic disease with a portfolio of available ASMs, the deci-
sion to introduce a new therapeutic alternative must follow a holistic evaluation of value provided.
Reflective Multi-Criteria Decision Analysis (MCDA) methodology allows to determine the value contribu-
tion of a treatment in a given indication considering all relevant criteria for healthcare decision-making in
a transparent and systematic manner from the perspective of relevant stakeholders.
Purpose: The aim of this study was to determine the relative value contribution of cenobamate in the
treatment of FOS in patients with DRE compared with third-generation ASMs using reflective MCDA-
based methodology.
Methods: A systematic literature review (combining biomedical databases and grey literature sources)
was performed to populate the Evidence and Value: Impact on DEcisionMaking (EVIDEM) MCDA frame-
work adapted to determine what represents value in the management of FOS in patients with DRE in
Spain. The study was conducted in two phases. The first took place in 2021 with a multi-stakeholder
group of eight participants. The second phase was conducted in 2022 with a multi-stakeholder group
of 32 participants. Participants were trained in MCDA methodology and scored four evidence matrices
(cenobamate vs. brivaracetam, vs. perampanel, vs. lacosamide and vs. eslicarbazepine acetate). Results
were analyzed and discussed in a group meeting through reflective MCDA discussion methodology.
Results: DRE is considered a very severe condition associated with many important unmet needs, mainly
with regard to the lack of more effective treatments to achieve the ultimate goal of treatment. Compared
to third-generation ASMs, cenobamate is perceived to have a better efficacy profile based on improve-
ments in responder rate and seizure freedom. Regarding safety, it is considered to have a similar profile to alternatives and a positive quality-of-life profile. Cenobamate results in lower direct medical costs (ex-
cluding pharmacological) and indirect costs. Overall, cenobamate is regarded as providing a high thera-
peutic impact and supported by high-quality evidence.
Conclusions: Based on reflective MCDA methodology and stakeholders’ experience in clinical manage-
ment of epilepsy in Spain, cenobamate is perceived as a value-added option for the treatment of patients
with DRE when compared with third-generation ASMs. | es |
dc.format | application/pdf | es |
dc.format.extent | 11 p. | es |
dc.language.iso | eng | es |
dc.publisher | Elsevier | es |
dc.relation.ispartof | Epilepsy and Behavior, 145, 109350. | |
dc.rights | Atribución 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | Drug-resistant epilepsy | es |
dc.subject | Focal-Onset Seizures | es |
dc.subject | Antiseizures medication | es |
dc.subject | Cenobamate | es |
dc.subject | Multi-criteria decision analysis | es |
dc.subject | Spain | es |
dc.title | Value Contribution of Cenobamate for the Treatment of Focal-Onset Seizures (FOS) in Patients with Drug-resistant Epilepsy (DRE) in Spain through Reflective Multi-Criteria Decision Analysis (MCDA) | es |
dc.type | info:eu-repo/semantics/article | es |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Farmacología | es |
dc.relation.publisherversion | https://doi.org/10.1016/j.yebeh.2023.109350 | es |
dc.identifier.doi | 10.1016/j.yebeh.2023.109350 | es |
dc.journaltitle | Epilepsy and Behavior | es |
dc.publication.volumen | 145 | es |
dc.publication.initialPage | 109350 | es |