THC:CBD Spray for MS Spasticity Is Cost-Effective, and Saves Money When Carer Costs Are Included | Research

The takeaway

A health economics model found that the THC:CBD spray Sativex for MS spasticity cost approximately 10,900 British pounds per quality-adjusted life year, well below the typical cost-effectiveness threshold, and actually saved money when home carer costs were included.

Read this if you are interested in the economics of cannabinoid medicine access and how cost-effectiveness shapes treatment availability.

Sativex saved 33,609 pounds per patient when carer costs were included

What the researchers found

Using a 30-year Markov model, researchers compared the costs and health outcomes of adding the THC:CBD spray Sativex to standard care versus standard care alone for moderate-to-severe MS spasticity in Wales.

The incremental cost was estimated at 3,836 British pounds per patient over 30 years, with an incremental cost-effectiveness ratio of 10,891 pounds per quality-adjusted life year. This is well below the 20,000-30,000 pounds threshold typically used in the UK to determine cost-effectiveness.

When the costs of home caregivers were factored in, the picture flipped dramatically. By reducing spasticity severity, Sativex reduced the need for intensive home care, generating estimated savings of 33,609 pounds per patient. In other words, the treatment more than paid for itself through reduced carer costs.

Why it matters

Health technology assessments determine whether treatments become available on public health systems. This analysis provides an economic justification for prescribing Sativex that goes beyond clinical effectiveness, showing it may actually save healthcare systems money when the full cost picture is considered.

The numbers in context

Incremental cost: 3,836 pounds per patient over 30 years. ICER: 10,891 pounds per QALY. With carer costs included: savings of 33,609 pounds per patient (ICER: -95,423 pounds per QALY, meaning dominant). Hospital admission costs had the greatest impact on the base case.

How the study worked

Markov model comparing THC:CBD plus standard care versus standard care alone over 30 years. Model parameters were drawn from clinical trials and real-world data. Sensitivity analysis examined the impact of hospital admission costs and carer costs on the results.

What this study cannot tell us

Health economic models rely on assumptions about disease progression, treatment continuation, and costs that may not hold over 30 years. The model was specific to Wales and may not generalize to other healthcare systems. Carer cost estimates involve significant uncertainty.

How to read the evidence

Well-structured Markov model with sensitivity analysis, but health economic models involve inherent uncertainty in long-term projections.

When this study was published

Published in 2016 using Welsh healthcare cost data. Drug pricing and care costs may have changed substantially.

The bigger picture

Cost-effectiveness analyses like this play a critical role in determining patient access to cannabinoid medicines through public health systems. The finding that Sativex may save money overall when caregiver burden is considered is particularly relevant as healthcare systems look for ways to manage the growing costs of chronic disease care.

Questions still open

Would similar cost-effectiveness be seen in other healthcare systems with different pricing and care structures? How do hospital admission rates for spasticity change in real-world Sativex use? Would generic THC:CBD products improve cost-effectiveness further?

Common questions

Is the THC:CBD spray cost-effective for MS spasticity?

Yes. This model found it cost 10,891 pounds per QALY, well below the UK cost-effectiveness threshold. When carer costs were included, it actually saved money.

How does reducing spasticity save money?

By controlling spasticity severity, Sativex reduced the need for intensive home care, which is extremely expensive over the long term. This offset and eventually exceeded the cost of the medication itself.

Read the original research

A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis.

Expert review of pharmacoeconomics & outcomes research, 16(6), 771-779

View on PubMed ↗

Citation

Gras, Adrien; Broughton, Julie. (2016). A cost-effectiveness model for the use of a cannabis-derived oromucosal spray for the treatment of spasticity in multiple sclerosis.. Expert review of pharmacoeconomics & outcomes research, 16(6), 771-779.