- Title
- Exploring the economic benefits of modafinil for post-stroke fatigue in Australia: a cost-effectiveness evaluation
- Creator
- Bajorek, Beata; Gao, Lan; Lillicrap, Tom; Bivard, Andrew; Garcia-Esperon, Carlos; Parsons, Mark; Spratt, Neil; Holliday, Elizabeth; Levi, Chris
- Relation
- Journal of Stroke and Cerebrovascular Diseases Vol. 29, Issue 11, no. 105213
- Publisher Link
- http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105213
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2020
- Description
- Background: In stroke survivors, post-stroke fatigue predicts dependency in daily living and failure to return to work. Modafinil shows promise as a pharmacotherapy to reduce post-stroke fatigue and related sequelae, e.g., poorer functional and clinical outcomes. Aims: This study explored the cost-effectiveness of modafinil in treating post-stroke fatigue in the Australian context, by determining its incremental cost-effectiveness ratio (ICER) and by simulating the potential cost-savings on a national scale, through a re-analysis of MIDAS trial data. Methods: A post hoc cost-effectiveness analysis was undertaken. Part A: patient-level cost and health effect data (Multidimensional Fatigue Inventory (MFI) scores) were derived from the MIDAS trial and analysis undertaken from a health-system perspective. Part B: a secondary analysis simulated the societal impact of modafinil therapy in terms of national productivity costs. Results: Part A: Mean cost of modafinil treatment was AUD$3.60/day/patient for a minimally clinically important change (10 points) in total MFI fatigue score, i.e., AUD$0.36/day/unit change in fatigue score per patient. For the base case scenario, the ICER of using modafinil (versus placebo) was AUD$131.73 ($90.17 - 248.15, for minimum and maximum costs, respectively). Part B: The potential productivity cost-savings to society were calculated as nearly AUD$467 million over 1 year, and up to $383,471,991,248 over 10 years, from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors, representing a significant societal benefit. Conclusions: Modafinil is a highly cost-effective treatment for post-stroke fatigue, offering significant productivity gains and potential cost-savings to society from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors.
- Subject
- modafinil; stroke; fatigue; cost analysis; cost-effectiveness; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1464906
- Identifier
- uon:47147
- Identifier
- ISSN:1052-3057
- Language
- eng
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