COST-BENEFIT-ANALYSIS OF RILUZOLE FOR THE TREATMENT OF AMYOTROPHIC-LATERAL-SCLEROSIS

We conducted a cost-benefit analysis of riluzole therapy in patients w ith amyotrophic lateral sclerosis (ALS: motor neuron disease: Lou Gehr ig's disease). The survival of patients with ALS increased by around 3 months as a result of riluzole therapy, from 3 to 3.25 years. A 3-mon th delay in hospitalisation was also expected as a result of riluzole therapy, resulting in a saving of $US40 per patient (1996 values). Thi s gain was opposed by the additional costs per patient of bimonthly se rum ALT monitoring ($US234), 2 days of extra day-hospital observation ($US369) and other medical costs ($US79), as well as extra outpatient visits ($US26) and coals of medication other than riluzole ($US90), re sulting from increased longevity. Using riluzole (at a cost of $US2247 per patient) resulted in an extra burden of $US757 on health services fur the gain of an extra 3 months of life expectancy. Thus, health-se rvice costs per life-year gained were $US12013. Despite the increase i n health-service costs as a result of increased longevity, the overall resource benefits to society from using riluzole amounted to $US2884 due to increased productivity benefits, giving a benefit : cost ratio of 1.28 : 1. Total benefits to society. including a valuation of 3 ext ra months of life ($US3599), amounted to $US6483, giving a benefit : c ost ratio of 2.89 : 1. Therefore, from a societal perspective, the pot ential benefits of riluzole in patients with ALS clearly exceed costs.