Section 5 of 6

Economic information and modeling report

10 evidence topics · 12 sources

Modeling overview

Cost-effectiveness analysis or health technology assessment of azetukalner

No evidence found.

Forecast United States revenue for azetukalner

“The revenue for Azetukalner is expected to reach an annual total of $651 mn by 2035 in the US based off GlobalData's Expiry Model.” (opens the source at this quote in a new tab)
“Applying the drug's phase transition success rate to remaining R&D costs and likelihood of approval (LoA) to sales related costs provides a risk-adjusted NPV model (rNPV).” (opens the source at this quote in a new tab)

Cenobamate cost-effectiveness against adjunctive comparators, United Kingdom

“We estimated the cost per quality-adjusted life-year (QALY) for cenobamate compared to brivaracetam, eslicarbazepine, lacosamide, and perampanel in the UK National Health Service over a lifetime time horizon.” (opens the source at this quote in a new tab)
“In the base case, cenobamate led to cost savings of £51 967 (compared to brivaracetam), £21 080 (compared to eslicarbazepine), £33 619 (compared to lacosamide), and £28 296 (compared to perampanel) and increased QALYs of 1.047 (compared to brivaracetam), 0.598 (compared to eslicarbazepine), 0.776 (compared to lacosamide), and 0.703 (compared to perampanel) per individual over a lifetime time horizon.” (opens the source at this quote in a new tab)
“Cenobamate improved QALYs and was less costly than brivaracetam, eslicarbazepine, lacosamide, and perampanel.” (opens the source at this quote in a new tab)

Technology appraisal of cenobamate for focal onset seizures

“Taking into account uncertainties with the clinical evidence, the most likely cost-effectiveness estimates for cenobamate are within what NICE normally considers an acceptable use of NHS resources.” (opens the source at this quote in a new tab)

Canadian reimbursement review of cenobamate cost-effectiveness

“The model took the perspective of the Canadian public health care payer over a lifetime horizon (i.e., 100 years).” (opens the source at this quote in a new tab)
“Results from the CADTH base case suggest that cenobamate may be associated with lower total costs (driven by fewer predicted seizure events) and greater health benefits (quality-adjusted life-years [QALYs]) compared with the alternative antiseizure medications (ASMs) considered in the economic model.” (opens the source at this quote in a new tab)
“However, these results should be interpreted with caution, given that the CADTH base case failed to address several key limitations of the economic evaluation.” (opens the source at this quote in a new tab)
“In the sponsor's base case, the budget impact of cenobamate was –$143,063 in Year 1, –$602,201 in Year 2, and –$1,027,859 in Year 3. The 3-year budget impact of cenobamate was –$1,773,123.” (opens the source at this quote in a new tab)

Cenobamate cost-effectiveness, Italian national health service perspective

“This study assesses the cost-effectiveness of cenobamate relative to brivaracetam, lacosamide, eslicarbazepine acetate, and perampanel in the management of focal onset seizures (FOS).” (opens the source at this quote in a new tab)
“A comprehensive cost-effectiveness analysis was performed using a lifetime horizon model that encompassed drug acquisition costs, background therapy, monitoring, and seizure management expenses.” (opens the source at this quote in a new tab)
“The cost-effectiveness analysis established that cenobamate is dominant across all evaluated treatment options, achieving greater QALYs at a lower total cost.” (opens the source at this quote in a new tab)

Cenobamate cost-effectiveness, Dutch societal perspective

“A Markov model was used to simulate lifetime costs and quality-adjusted life years (QALYs) for cenobamate compared to perampanel, brivaracetam, and lacosamide from the Dutch societal perspective.” (opens the source at this quote in a new tab)
“Cenobamate was associated with an average total cost of €466,560 and 9.922 QALY gained.” (opens the source at this quote in a new tab)
“Probabilistic sensitivity analyses revealed that at the willingness to pay threshold of €50,000/QALY, the probability that cenobamate is cost-effective was 100%.” (opens the source at this quote in a new tab)

Economically justifiable price of cenobamate, Spain

“To determine the economically justifiable price (EJP) of cenobamate to become a cost-effective alternative compared with third-generation anti-seizure medications in the treatment of focal-onset seizures (FOS) in adult patients with drug-resistant epilepsy (DRE) in Spain.” (opens the source at this quote in a new tab)
“Base-case shows that cenobamate's daily EJP of €7.30 is cost-effective for a threshold of €21,000/QALY.” (opens the source at this quote in a new tab)
“At a daily price of €5.45, cenobamate becomes dominant over all treatment alternatives producing cost-savings for the national health system (NHS).” (opens the source at this quote in a new tab)

Budget impact of cenobamate, Belgian healthcare payer perspective

“A prevalence-based budget impact model (BIM) was developed from the perspective of the Belgian NIHDI, considering all direct healthcare costs over a 3-year time horizon.” (opens the source at this quote in a new tab)
“Over a 3-year period, considering the cumulative drug costs of cenobamate, replacement of other third-generation ASMs, and savings generated at medical cost level, the introduction of cenobamate as adjunctive treatment for the target population was estimated to reduce the NIHDI budget by -€8,105,616.” (opens the source at this quote in a new tab)
“The savings at medical cost level fully offset the impact of cenobamate on the drug budget, leading to an overall healthcare budget saving of -€8,105,616 for NIHDI.” (opens the source at this quote in a new tab)

Cost-effectiveness of antiseizure medications for focal epilepsy, United States societal perspective

“We used a Markov model to evaluate the lifetime cost-effectiveness of 10 ASMs in the treatment of focal epilepsy, with lacosamide (LCM) as a control, from the perspective of society in the United States.” (opens the source at this quote in a new tab)
“Willingness to pay was defined as $150 000 per quality-adjusted life year (QALY).” (opens the source at this quote in a new tab)
“Most traditional ASMs are more cost-effective than new ASMs; OXC is an exception.” (opens the source at this quote in a new tab)

Budget impact model

Approach and framework

No evidence found.

Perspective and time frame

No evidence found.

Epidemiology and eligible population inputs

No evidence found.

Cost assumptions

No evidence found.

Model outcomes

No evidence found.

Results

Base case

No evidence found.

Scenario analyses

No evidence found.

Budget impact model discussion

Summary

No budget impact model for azetukalner has been published. Xenon Pharmaceuticals has announced no price, reports no approved products and no product revenue, and the New Drug Application for focal seizures was submitted on 17 September 2026. Azetukalner does not appear in the Prime Therapeutics quarterly drug pipeline reports published in April 2026 and July 2026. Until a price is set, the closest available analogues are the published budget impact analyses of cenobamate, the most recently approved branded adjunctive antiseizure medication for drug-resistant focal epilepsy. Both are non-US: a Belgian model estimated a three-year reduction of 8,105,616 euros in the national payer budget, and the analysis submitted to the Canadian reimbursement review estimated a three-year budget impact of 1,773,123 Canadian dollars in savings. Both attribute the net saving to reduced seizure-related medical costs offsetting drug acquisition cost, so the magnitude of any azetukalner budget impact will depend on its price and on the extent to which it displaces rather than adds to existing antiseizure medications.