Application of health technology assessment in selection of third-generation anti-seizure medications perampanel and lacosamide
AIM To provide reference for selection and clinical rational use of third-generation anti-seizure medications in medical institutions through a comprehensive evaluation of perampanel and lacosamide.METHODS A percentage based evaluation system was developed based on the Quick Guide for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition).Referring to drug instructions,clinical treatment guidelines,and relevant literature,perampanel and lacosamide were quantitatively scored from five dimensions of pharmaceutical characteristics,effectiveness,safety,economy,and other attributes.RESULTS The final evaluation score was 77.41 for perampanel and 69.06 for lacosamide.The score of perampanel was higher than 70,so the recommendation for entering the drug use catalog of medical institutions was"strong recommendation".There was a significant difference in effectiveness and economy between the two drugs.Perampanel had more evidence-based proofs and indications for the treatment of drug-resistant epilepsy and lower average daily treatment cost,so the effectiveness and economy of perampanel was slightly better than that of lacosamide.However,in terms of safety,perampanel had a Boxed Warning from the U.S.Food and Drug Administration about severe psychiatric and behavioral reactions,and it was not as recommended as lacosamide in patients with pregnancy or liver dysfunction.CONCLUSION Perampanel and lacosamide each have advantages in different attributes,and medical institutions can decide whether to introduce them based on the characteristics of patient population and the availability of alternative drugs.
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