Abstract | BACKGROUND: METHODS: A 10-year Markov model, incorporating a 6-week acute phase and a maintenance phase across three health states (discontinuation, relapse, death) was constructed. Six-week probabilities of discontinuation and adverse events were based on a published independent mixed-treatment comparison; long-term risks of relapse and discontinuation were from an indirect comparison. Costs included drug therapy, relapse, and outpatient, primary and residential care. Costs and benefits were discounted at 3.5 %. Utility estimates were taken from published literature, and cost effectiveness was expressed as total 10-year incremental costs and quality-adjusted life-years (QALYs). RESULTS:
Lurasidone yielded a cost saving of £3383 and an improvement of 0.005 QALYs versus aripiprazole, in Scotland. Deterministic sensitivity analysis demonstrated that results were sensitive to relapse rates, while probabilistic sensitivity analysis suggested that lurasidone had the highest expected net benefit at willingness-to-pay thresholds of £20,000-30,000 per QALY. The probability that lurasidone was a cost-effective treatment strategy was approximately 75 % at all willingness-to-pay thresholds, with similar results being obtained for the Welsh analysis. CONCLUSIONS: Our analysis suggests that lurasidone would provide an effective, cost-saving alternative for the healthcare service in the treatment of adult patients with schizophrenia.
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Authors | Krithika Rajagopalan, David Trueman, Lydia Crowe, Daniel Squirrell, Antony Loebel |
Journal | PharmacoEconomics
(Pharmacoeconomics)
Vol. 34
Issue 7
Pg. 709-21
(07 2016)
ISSN: 1179-2027 [Electronic] New Zealand |
PMID | 27067724
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antipsychotic Agents
- Aripiprazole
- Lurasidone Hydrochloride
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Topics |
- Adult
- Antipsychotic Agents
(adverse effects, economics, therapeutic use)
- Aripiprazole
(adverse effects, economics, therapeutic use)
- Cost-Benefit Analysis
- Financing, Personal
(economics)
- Humans
- Lurasidone Hydrochloride
(adverse effects, economics, therapeutic use)
- Markov Chains
- Quality-Adjusted Life Years
- Recurrence
- Schizophrenia
(drug therapy, economics)
- Scotland
- Wales
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