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Systematic Review of the Costs and Benefits of Prescribed Cannabis-Based Medicines for the Management of Chronic Illness: Lessons from Multiple Sclerosis

Author

Listed:
  • Samuel Herzog

    (NHMRC Clinical Trials Centre, The University of Sydney)

  • Marian Shanahan

    (The University of New South Wales)

  • Peter Grimison

    (Chris O’Brien Lifehouse)

  • Anh Tran

    (NHMRC Clinical Trials Centre, The University of Sydney)

  • Nicole Wong

    (NHMRC Clinical Trials Centre, The University of Sydney)

  • Nicholas Lintzeris

    (The University of Sydney
    South East Sydney Local Health District)

  • John Simes

    (NHMRC Clinical Trials Centre, The University of Sydney
    Chris O’Brien Lifehouse)

  • Martin Stockler

    (NHMRC Clinical Trials Centre, The University of Sydney
    Chris O’Brien Lifehouse)

  • Rachael L. Morton

    (NHMRC Clinical Trials Centre, The University of Sydney
    NHMRC Clinical Trials Centre, The University of Sydney)

Abstract

Introduction Cannabis-based medicines (CBMs) may offer relief from symptoms of disease; however, their additional cost needs to be considered alongside their effectiveness. We sought to review the economic costs and benefits of prescribed CBMs in any chronic illness, and the frameworks used for their economic evaluation. Methods A systematic review of eight medical and economic databases, from inception to mid-December 2016, was undertaken. MeSH headings and text words relating to economic costs and benefits, and CBMs were combined. Study quality was assessed using relevant checklists and results were synthesised in narrative form. Results Of 2514 identified records, ten studies met the eligibility criteria, all for the management of multiple sclerosis (MS). Six contained economic evaluations, four studies reported utility-based quality of life, and one was a willingness-to-pay study. Four of five industry-sponsored cost–utility analyses for MS spasticity reported nabiximols as being cost-effective from a European health system perspective. Incremental cost-effectiveness ratios per quality-adjusted life-year (QALY) gained for these five studies were £49,257 (UK); £10,891 (Wales); €11,214 (Germany); €4968 (Italy); and dominant (Spain). Nabiximols for the management of MS spasticity was not associated with statistically significant improvements in EQ-5D scores compared with standard care. Study quality was moderate overall, with limited inclusion of both relevant societal costs and discussions of potential bias. Conclusions Prescribed CBMs are a potentially cost-effective add-on treatment for MS spasticity; however, this evidence is uncertain. Further investment in randomised trials with in-built economic evaluations is warranted for a wider range of clinical indications. Systematic review registration PROSPERO Registration Number: CRD42014006370.

Suggested Citation

  • Samuel Herzog & Marian Shanahan & Peter Grimison & Anh Tran & Nicole Wong & Nicholas Lintzeris & John Simes & Martin Stockler & Rachael L. Morton, 2018. "Systematic Review of the Costs and Benefits of Prescribed Cannabis-Based Medicines for the Management of Chronic Illness: Lessons from Multiple Sclerosis," PharmacoEconomics, Springer, vol. 36(1), pages 67-78, January.
  • Handle: RePEc:spr:pharme:v:36:y:2018:i:1:d:10.1007_s40273-017-0565-6
    DOI: 10.1007/s40273-017-0565-6
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. Takeru Shiroiwa & Yoon‐Kyoung Sung & Takashi Fukuda & Hui‐Chu Lang & Sang‐Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437, April.
    3. Joanna Coast & Richard Smith & Paula Lorgelly, 2008. "Should the capability approach be applied in Health Economics?," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 667-670, June.
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    1. Mohammed Al‐Hamdani & Kayla M. Joyce & Tristan Park & Megan E. Cowie & Sherry H. Stewart, 2021. "Cannabis packaging: An opportunity for facilitating informed decisions," Journal of Consumer Affairs, Wiley Blackwell, vol. 55(3), pages 1150-1168, September.

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