A pharmacoeconomic evaluation of botulinum toxin in the treatment of spasmodic torticollis

We performed a prospective study in 21 patients to evaluate the cost of tre atment of spasmodic torticollis (cervical dystonia) before and after botuli num toxin type A (BTA) treatment and to assess the impact of BTA treatment on quality of life. Data were recorded for the analysis over a period start ing 8 months before and ending 7.2 +/- 0.2 months (mean +/- SEM) after the first injection of BTA. All patients received at least two BTA injections ( 2.9 +/- 0.2 injections per patient). We studied direct medical costs (drugs , outpatient and inpatient visits, diagnostic procedures, physiotherapy), c linical effects of BTA (clinical rating scale and patient's global assessme nt), quality of life (French version of the Nottingham Health Profile [NHP] ), and adverse reactions. Costs associated with the treatment of spasmodic torticollis before the first BTA injection were 479 +/- 143 French Francs ( FF)/patient/month (97 +/- 29 US $/pt/mo). During BTA treatment, costs were 1,126 +/- 147 FF/pt/mo (228 +/- 30 US $/pt/mo), including a mean cost of BT A of 771 +/- 131 FF/pt/mo (157 +/- 27 US $/pt/mo). Treatment with BTA signi ficantly decreased clinical symptoms of spasmodic torticollis and improved the emotional, social, and pain-related domains of the quality of life asse ssment. Botulinum toxin type A treatment increases the cost of treating spa smodic torticollis but improves quality of life in terms of pain, social, a nd psychologic functioning in patients with spasmodic torricollis.