Summary
Background
It is accepted that the three commercially available type A botulinum toxins (BoNT-As)
are different, their units of potency are not interchangeable and no fixed dose conversion
ratio exists between them. To date, there is no clear evidence demonstrating the superiority
of one toxin over another clinically.
Objective
The study aims to identify evidence confirming the equivocal efficacy of the formulations
and to justify that attention can therefore be reasonably turned to their differing
costs as a means of aiding choice of treatment. This is achieved via the development
of the cost calculator presented herein, to enable direct economic comparisons to
be made between the three commercially available BoNT-A formulations licensed for
aesthetic indications in the UK.
Methods
An online literature search using PubMed was undertaken and the latest available information
on the cost for each BoNT-A treatment was accessed via the British National Formulary
(BNF). Predicated on the evidence review, a cost calculator was developed which takes
into account for the glabella: the number of treatments needed per patient with each
product over a year and the number of treatments available with differing dilutions
of each vial of each product over a year. A range of cost prices can also be introduced
allowing a direct cost-comparison to be made for treating the glabella of a set number
of patients over a year between different products.
Results
Azzalure® (abobotulinumtoxinA) was the most cost-effective in almost all scenarios tested,
whilst Vistabel® (onabotulinumtoxinA) was the least cost-effective. Of the two products with published
non-inferiority with respect to each other, onabotulinumtoxinA and Bocouture® (incobotulinumtoxinA), incobotulinumtoxinA offered a lower overall cost to treat
the glabella of the same number of patients when compared with Vistabel.
Conclusion
In most scenarios, BoNT-A treatment with abobotulinumtoxinA will result in significant
annual cost savings when compared with treatment with onabotulinumtoxinA or incobotulinumtoxinA.
Keywords
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Article info
Publication history
Published online: January 06, 2012
Accepted:
December 1,
2011
Received:
September 6,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
