Cost-utility analysis of riluzole treatment compared with supportive care for patients with amyotrophic lateral sclerosis

Authors

Thaiphat Rattana-amonloet, Master’s Degree Program in Pharmacy Management, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandFollow
Ampai Pimkrai, Department of pharmcy, Chiang Mai Neurological Hospital, Chiang Mai, ThailandFollow
Piyameth Dilokthornsakul, Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandFollow
Unchalee Permsuwan, Department of Pharmaceutical Care, Center for Medical and Health Technology Assessment, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandFollow

Abstract

Background: In Thailand, riluzole, a drug used to treat amyotrophic lateral sclerosis (ALS), was costly and had not yet been included in the National List of Essential Medicines. In addition, no studies have been conducted on the cost-effectiveness of the drug. Objective: This study aimed to evaluate the cost-utility of riluzole in treating patients with ALS compared with supportive care from the perspective of societal and health-care providers. Methods: A Markov model was employed to analyze costs and benefits from a societal and the health-care provider’s perspective. Outcomes were measured in quality-adjusted life years (QALYs). The analysis calculated an incremental cost-effectiveness ratio (ICER). Costs were collected from ALS patients at Chiang Mai Neurological Hospital during 2022–2023. Utility and transition probabilities of health state were derived from literature reviews. Both costs and outcomes were discounted at an annual rate of 3%. Sensitivity analyses, including one-way and probabilistic, were conducted. Results: From the societal perspective, the use of riluzole incurs a higher cost than supportive care, costing 983,183 THB (26,863 USD) and improved health outcomes at 1.79 QALYs. This yielded an ICER of 6,000,785 THB/QALY (163,956 USD/QALY). From the provider’s perspective, the ICER is calculated at 5,988,883 THB/QALY (163,631 USD/QALY). Conclusion: The use of riluzole in the treatment of ALS is not a cost-effective option when compared to Thailand’s willingness-to-pay threshold of 160,000 THB/QALY (4,372 USD/QALY).

DOI

10.56808/3027-7922.2996

Recommended Citation

Rattana-amonloet, Thaiphat; Pimkrai, Ampai; Dilokthornsakul, Piyameth; and Permsuwan, Unchalee (2025) "Cost-utility analysis of riluzole treatment compared with supportive care for patients with amyotrophic lateral sclerosis," The Thai Journal of Pharmaceutical Sciences: Vol. 49: Iss. 1, Article 6.
DOI: https://doi.org/10.56808/3027-7922.2996
Available at: https://digital.car.chula.ac.th/tjps/vol49/iss1/6