Cost-effectiveness analysis of topiramate versus phenobarbital in the treatment of children with febrile seizure in Shiraz

Febrile seizure is the most common disorder in childhood, with a prevalence of 2% to 5%. There are many drugs for treatment of this disease; however, the most common prescribed medication in Iran is phenobarbital that is cheap, but it has many side effects. Topiramate is a medication with fewer side effects that is currently prescribed in Iran only for patients with epilepsy; also, it has recently been prescribed and tested for children with febrile seizure. The aim of this study was to compare the cost-effectiveness of topiramate versus phenobarbital in patients with febrile seizure in the south of Iran in 2017. This econometric cost-effectiveness and cost-utility study was conducted on 91 patients with febrile seizure to assess two strategies of oral drug therapy including phenobarbital and topiramate in 2016-2017. Of all, 51 patients were treated with phenobarbital and 40 patients received topiramate. In order to collect the required data, we followed up the patients for six months, using a randomized and single-blinded approach. In this study, a decision tree model was used. The outcomes of the model included febrile seizure and utility. The study was conducted from the perspective of the community; therefore, direct and indirect costs were included in the study. Excel and TreeAge software (2011) were used to analyze the results. The results showed that topiramate was cheaper and more effective than phenobarbital. In patients in the phenobarbital and topiramate groups, the mean costs were $740 and $674 per ppp, utility scores were 0.72 and 0.82, and febrile seizure without side effects were 0.3 and 0.6, respectively. Moreover, one-way sensitivity analysis confirmed the robustness of the results of the study. According to the results, topiramate in patients with febrile seizure is a fully cost-effective and cost-efficient strategy that can be suggested as a better alternative for children with febrile seizure.