Cost-effectiveness of Cerebrolysin as an add-on treatment for neurorecovery after traumatic brain injury.

Abstract

Traumatic brain injuries (TBIs) are a leading cause of death and long-term disability worldwide, with incidence and injury mechanisms varying by age group and region. Impairment of functional status, diagnoses of anxiety and depression are encountered post-TBI. Studies have shown that Cerebrolysin can have positive effects among TBI survivors. We conducted a cost-effectiveness analysis (CEA) among patients with moderate TBI, using data from the CAPTAIN II trial. This exercise was carried out on a three-month timeline from the provider's perspective. Two models were incorporated in the CEA: control (placebo group) and treatment (Cerebrolysin group). Our analysis showed that Cerebrolysin had a high probability of being cost-effective, based on Glasgow Outcome Scale Extended (GOSE) (in over 80% of patients with moderate TBI), Hospital Anxiety and Depression Scale (HADS) Depression and Anxiety scores (for the former two, in over 95% of patients with moderate TBI), when assuming a lasting effect (12 months) of the CAPTAIN trial intervention protocol. A model-based approach is needed to account for potential sources of bias beyond the 90-day observation period of this clinical trial. Furthermore, economic evaluations incorporating patients diagnosed with all TBI severities are needed.