PharmacoEconomics & Outcomes News | 2021
Medicinal cannabis may be cost effective for alleviating refractory symptoms associated with chronic conditions
Abstract
Medicinal cannabis-based products may be cost-effective treatment options for the management of spasticity in multiple sclerosis (MS), Dravet syndrome (DS) and neuropathic pain, according to a literature review conducted by researchers from Australia. The researchers conducted a systematic literature search to examine the currently available evidence on the cost effectiveness of medicinal cannabis-based products for management of refractory symptoms associated with chronic conditions. The literature search identified 12 studies, conducted between 2012 and 2020, that examined the cost effectiveness of medicinal cannabis in MS (n = 8), paediatric drug-resistant epilepsies (n = 2) such as DS and Lennox-Gastaut syndrome (LGS), and chronic pain (n = 2). Nabiximols, a cannabis plant extract containining cannabidiol (CBD) and tetrahydrocannabinol (THC) at a 1:1 ratio, was found to be cost effective for MS spasticity in 6 of 7 studies conducted in European settings, with incremental cost-effectiveness ratios (ICERs) ranging from €4968 to €35 516 per QALY gained in Italy, from €11 060 to €11 214 per QALY gained in Germany, and with cost savings in Spain. However, nabiximols was not cost effective for MS spasticity in a study from the UK. Adjunctive cannabinoid oil was found to be cost effective for DS in a Canadian setting, with an ICER of $Can32 399 per QALY gained, but CBD oral solution was not a cost-effective option for patients with LGS in a US setting. For the treatment of neuropathic pain, second-line adjunctive smoked cannabis was found to be cost effective in the US, with an ICER of $US48 594 per QALY gained. The overall reporting quality of the studies, assessed using the CHEERS* checklist, was good, ranging from 70% to 100%.