Objective: To carry out a cost-analysis based on the respective recommended dosing per muscle using IncobotulinumtoxinA (INCO) and AbobotulinumtoxinA (ABO) for the treatment of post-stroke upper limb spasticity (PSULS).

Background: Data related to the comparative cost of PSULS treatment with INCO vs ABO is scarce.

Method: Recommended doses per muscle were extracted from both Canadian product monographs and the dose conversion ratios (lower and upper ranges) were calculated. Overall cumulative botulinumtoxinA (BoNT-A) costs over a period of 5 years were calculated using BoNT-A costs drawn from Canadian public databases. The assumptions were made that 3-month treatment cycles were used and that all other post-stroke management-associated costs remained the same for both BoNT-A products (i.e., administration cost, caregiver cost, hospital cost, work absenteeism, etc.). To minimize waste of BoNT-A products, the most efficient combination of vials was selected.

Results: The calculated INCO:ABO conversion ratio was 1:4.25. Based on a dose of 400U of INCO and current BoNT-A products costs, the cumulative costs ($CAD) of a 5 year treatment regimen is 26,400$ for INCO and 46,231$ for ABO (equivalent dose of 1700U). As per ABO’s Canadian product monograph, the maximum dose is 1500U. In this case, the cumulative costs over a period of 5 years is 38,520$. Similar cumulative costs were obtained when calculation was performed using the conversion ratio determined from the average dose per clinical patterns (1:4.21).

Conclusion: to the clinical conversion ratio of 1:4.25, INCO is more cost-effective than ABO in PSULS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cost-analysis-of-the-use-of-incobotulinumtoxina-and-abobotulinumtoxina-for-the-treatment-of-post-stroke-upper-limb-spasticity-based-on-recommended-dosing-for-muscles-and-clinical-patterns/