OBJECTIVES: Huntington’s disease (HD) is a multifaceted neurodegenerative disorder characterized by involuntary movements, specifically chorea, as well as behavioral and psychiatric disturbance, and cognitive dysfunction. Tetrabenazine was the first approved treatment for chorea, although tolerability concerns exist. The main aim of this study was to perform cost-effectiveness analysis of using tetrabenazine for treating chorea in patients with HD in Russia.

METHODS: Analysis of the published clinical trials was conducted to evaluate comparative efficacy and safety of using different types of drugs for the treatment of chorea in HD used in Russia – tetrabenazine and neuroleptics (tiapride, olanzapine, risperidone, aripiprazole, ziprasidone and quetiapine). MS Excel based model of medical care patients with HD has been developed for the Russian Healthcare System. To measure costs for the treatment of chorea in HD with different types of drugs for the state budget were used “cost-effectiveness” analysis (CEA) and budget impact analysis (BIA). Direct medical costs included drugs, for neuroleptics the average cost of 1-year therapy were calculated. The prevalence of tardive dyskinesia was included into the model as the effectiveness criteria.

RESULTS: The CEA has shown that in comparison with neuroleptics ($1964) CER for tetrabenazine was $827 per 1 year without tardive dyskinesia. The difference amounted to 56% in favor of tetrabenazine. The BIA has shown that annual savings with an increase proportion of tetrabenazine up to 100% during 5 years will be 36% (rate for July 2020). This will additionally treat 234 patients with HD with chorea.

CONCLUSIONS: Using tetrabenazine for treating chorea in patients with HD was effective and economically justified treatment option in Russia.