“Cost consequence” assessment of the management of children with cerebral palsy treated with botulinum toxin: BOTULOSCOPE (French observatory practices) E. Chaléat-Valayer1, I. Jaisson-Hot2, B. Parratte3,

Abstract

Background: To estimate the economic impact (cost to the hospital) of botulinum toxin injections in the treatment of cerebral palsy patients with spasticity of the lower limbs.
Methods: Children included in the observatory Botuloscope, multicenter study evaluating a
consecutive series of children with cerebral palsy aged between 2 and 16 with disabling focal spasticity.
The cost study was conducted in view of the hospital. Hospital direct costs (2004) were those induced by the use of botulinum toxin to 12 months.
Results: Two hundred and forty children were included, 486 toxin injection sessions were conducted for these children during the follow-up. The average cost of one injection session (toxin + analgesia + consultation or hospitalization) was estimated for all children to € 731, more than half the toxin and analgesia. Over 12 months, the cost of hospital care for children was estimated at just over € 2,500.
Conclusion: Since 2009, there is a specific Diagnosis Related Group for toxin injection in ambulatory, valued at € 375.55 in 2014, this reimbursement does not cover the means for injecting a session cost as we could calculate. The price of Diagnosis Related Group does not take into effect not count (1) the number of injected muscles, (2) the number of members treated, (3) the level of dependency of the patient, (4) doses of toxin injected, and (5) the need
for a heavy or non-analgesic procedure.