Abstract:
:Patients with schizophrenia suffer numerous relapses and rehospitalizations that are associated with high direct and indirect medical expense. Suboptimal therapeutic efficacy and, in particular, problems with compliance are major factors leading to relapse. Atypical antipsychotic agents offer improved efficacy and a lower rate of extrapyramidal adverse effects compared with conventional antipsychotic drugs. Long-acting intramuscular risperidone combines these benefits with improvements in compliance associated with depot injections. To assist decision making regarding the place of long-acting risperidone in therapy, a cost-effectiveness analysis of strategies involving first-line treatment with long-acting risperidone, oral olanzapine or depot haloperidol was performed from the perspective of the Belgian healthcare system. A decision tree model was created to compare the cost effectiveness of three first-line treatment strategies in a sample of young schizophrenic patients who had been treated for 1 year and whose disease had not been diagnosed for longer than 5 years. The model used a time horizon of 2 years, with health state transition probabilities, resource use and cost estimates derived from clinical trials, expert opinion and published prices. The four health states in the model were derived from an analysis of the literature. The principal efficacy measure was the proportion of patients successfully treated, defined as those who responded to initial treatment and who had none to two episodes of clinical deterioration without needing a change of treatment over the 2-year period. Comprehensive sensitivity analysis was carried out to test the robustness of the model. A greater proportion of patients were successfully treated with long-acting risperidone (82.7%) for 2 years, compared with those treated with olanzapine (74.8%) or haloperidol (57.3%). Total mean costs per patient over 2 years were 16,406 Euro with long-acting risperidone, 17,074 Euro with olanzapine and 21,779 Euro with haloperidol (year of costing 2003). The mean cost-effectiveness ratios were 19,839 Euro, 22,826 Euro and 38,008 Euro per successfully treated patient for long-acting risperidone, olanzapine and haloperidol, respectively. Results of the sensitivity analysis confirmed that the results were robust to a wide variation of different input variables (effectiveness, dosing distribution, patient status according to healthcare system). Long-acting risperidone was the dominant strategy, being both more effective and less costly than either oral olanzapine or depot haloperidol. Long-acting risperidone appears to represent a favourable first-line strategy for patients with schizophrenia requiring long-term maintenance treatment.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
De Graeve D,Smet A,Mehnert A,Caleo S,Miadi-Fargier H,Mosqueda GJ,Lecompte D,Peuskens Jdoi
10.2165/00019053-200523001-00004subject
Has Abstractpub_date
2005-01-01 00:00:00pages
35-47eissn
1170-7690issn
1179-2027journal_volume
23 Suppl 1pub_type
杂志文章abstract:OBJECTIVE:The aim of the study was to determine the costs and effects associated with a community pharmacy-based smoking-cessation programme in Northern Ireland, using the perspective of the payer in the main analysis. DESIGN AND SETTING:Data from a pilot study conducted in 2 community pharmacies in Northern Ireland w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814030-00008
更新日期:1998-09-01 00:00:00
abstract::This article explores the need to perform pharmacoeconomic evaluations of herbal medicines and assesses the extent to which this approach has been applied so far to these products. There seems to be no compelling need for pharmacoeconomic analyses of herbal over-the-counter medicines, but such analyses are certainly w...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018010-00001
更新日期:2000-07-01 00:00:00
abstract::The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficien...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119060-00001
更新日期:2001-01-01 00:00:00
abstract::Open-heart surgery (OHS) is performed to bypass occluded arteries, replace malfunctioning cardiac valves or correct congenital abnormalities. The average cost of OHS varies from $US25 057-$US79 795 (1997 values). The objective of this paper was to review economic studies of pharmacological strategies in open-heart sur...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200321040-00003
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Invasive fungal infections in neutropenic patients treated for haematological malignancies are associated with a high mortality rate and, therefore, require early treatment. As the diagnosis of invasive fungal infections is difficult, effective antifungal prophylaxis is desirable. So far, fluconazole has bee...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200826010-00007
更新日期:2008-01-01 00:00:00
abstract::Rufinamide (Inovelon®), a triazole derivative, is an oral antiepileptic drug approved in the EU as adjunctive therapy in the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients aged ≥4 years. The efficacy of oral rufinamide as adjunctive therapy in patients with LGS uncontrolled on one to t...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11208630-000000000-00000
更新日期:2012-03-01 00:00:00
abstract::Disease management is a systematic approach to a health condition or a healthcare intervention that organises preventative, interventional and care approaches throughout the continuum of care and which measures outcomes in terms of populations, not individuals. Disease management's advantage over the current component...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199814010-00002
更新日期:1998-07-01 00:00:00
abstract::Scientific reviewing methods were applied to economic studies of influenza vaccination, and an economic model of influenza vaccination was developed from these primary sources. Issues arising from the secondary literature review include the quality of evidence on the effectiveness of the vaccines, the absence of a tra...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199600093-00015
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:During the 1990s, a number of new cytotoxic agents with clinically relevant activity in non-small-cell lung cancer (NSCLC), and with a more favourable therapeutic index than drugs already in use, became available. Given the high prices of these new drugs and the large number of patients affected, it is impor...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523110-00007
更新日期:2005-01-01 00:00:00
abstract::Due to a single error in the annual cost of sarilumab the following needs to be corrected in the article. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-019-00857-7
更新日期:2020-01-01 00:00:00
abstract::As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of vedolizumab (Takeda UK) to submit evidence of the clinical effectiveness and cost effectiveness of vedolizumab for the treatment of patients with moderate-to-severe active ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0334-3
更新日期:2016-03-01 00:00:00
abstract::Multiple sclerosis (MS) is a disease of the CNS, typically striking adults during the primary productive time of their life. The symptoms of MS can restrict the individual's physical activity and income-earning ability, resulting in a major financial burden on the patient, family, health system and society. This syste...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/11532230-000000000-00000
更新日期:2010-01-01 00:00:00
abstract::The past few years have seen rapid changes in the methods of decision-analytic modelling of healthcare programmes for the purposes of economic evaluation. This paper focuses on four developments in modelling that have emerged over the past few years or have become more widely used. First, no one optimal method for ext...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624110-00002
更新日期:2006-01-01 00:00:00
abstract::The progressive disability of Parkinson's disease results in substantial burdens for patients, their families and society in terms of increased health resource use, poorer quality of life, caregiver burden, disrupted family relationships, decreases in social and leisure activities, deteriorating emotional well-being, ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119070-00003
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The ARTEMIS trial compared first-line antiretroviral therapy (ART) with lopinavir/ritonavir (LPV/r) to darunavir plus ritonavir (DRV + RTV) for HIV-1-infected subjects. In order to fully assess the implications of this study, economic modelling extrapolating over a longer term is required. OBJECTIVE:The aim...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-013-0048-3
更新日期:2013-05-01 00:00:00
abstract::In this paper we consider the evolving American healthcare landscape and what it means for the use of economic evaluation of health interventions. We emphasise that use of economic evaluation in the US is unlikely to follow the European, Canadian or Australian models, which use cost effectiveness openly and explicitly...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624110-00012
更新日期:2006-01-01 00:00:00
abstract::Appropriate discounting rules in economic evaluations have received considerable attention in the literature and in national guidelines for economic evaluations. Rightfully so, as discounting can be quite influential on the outcomes of economic evaluations. The most prominent controversies regarding discounting involv...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-018-0672-z
更新日期:2018-07-01 00:00:00
abstract::Studies have not previously reported the indirect cost burden of multiple sclerosis (MS) from an employer perspective. To compare annual indirect costs between privately insured US employees with MS and matched employee controls. A retrospective analysis of a privately insured claims database containing disability dat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11314700-000000000-00000
更新日期:2009-01-01 00:00:00
abstract::Given the policy relevance and growing volume of research measuring individuals' willingness to pay (WTP) for health-related goods and services, meta-analysis provides a potentially rich set of tools for answering key questions about this research area. In particular, when taken as a whole, what does the existing empi...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200826110-00003
更新日期:2008-01-01 00:00:00
abstract::Clinical studies have shown that the combination of an inhaled corticosteroid (ICS) and a long-acting beta(2)-adrenoceptor agonist (LABA) for patients with asthma is more effective than the use of ICS alone in equivalent or higher doses, as well as the use of other combinations. However, the relatively higher acquisit...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200624100-00005
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to identify, among the information routinely collected on patients in intensive care units (ICUs), data that determine the total cost for a given patient. DESIGN:We developed a model that could help physicians in medical ICUs to estimate the cost of care for their patients when no cost data...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-199915060-00005
更新日期:1999-06-01 00:00:00
abstract:INTRODUCTION:Mixture modelling is increasingly being considered where a potential cure leads to a long life. Traditional methods use relative survival models for frail populations or cure models that have improper survival functions with theoretical infinite lifespans. Additionally, much of the work uses population dat...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-019-00867-5
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:Patients with chronic kidney disease (CKD) are commonly treated with renin-angiotensin-aldosterone system inhibitors (RAASi) in order to delay progression of renal disease. However, research has shown that RAASi in CKD patients increases hyperkalaemia (HK) prevalence, which leads to RAASi discontinuation or ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00902-w
更新日期:2020-07-01 00:00:00
abstract::This willingness-to-pay (WTP) analysis is the first study of its kind undertaken in Australia to support an application for listing of a new drug on the Australian national formulary. The technique offers the advantage of being able to summarise diverse outcomes of therapy in a single unit of measure. Willingness to p...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813030-00009
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To estimate savings in the cost of caring for patients with Alzheimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship between disease progression and institutionalisation. DESIGN AND SETTING:We assessed the relation...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200017040-00005
更新日期:2000-04-01 00:00:00
abstract::Currently, the most important issue in US pharmaceutical policy is probably cost containment. Research into pharmaceutical issues should therefore concentrate on this area. Analysis of changing trends in pharmaceutical expenditures, particularly during the early 1990s, would be a useful starting point. Research into t...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199600102-00019
更新日期:1996-01-01 00:00:00
abstract:AIM:To assess the relative cost effectiveness of escitalopram compared with venlafaxine XR in patients with major depressive disorder (MDD). METHODS:An economic evaluation was conducted alongside a double-blind, multinational, randomised clinical trial and examined the costs and quality of life of 251 patients taking ...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00019053-200523020-00007
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to evaluate the potential economic implications of using etoricoxib versus non-selective NSAID alternatives in the treatment of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) in the UK. STUDY DESIGN:Decision-analytical modelling was used to calculate the exp...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200422100-00003
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:In Ireland, all new drugs are considered for a formal pharmacoeconomic evaluation (PE) prior to a reimbursement decision. All evaluations are conducted by the National Centre for Pharmacoeconomics (NCPE). The objectives of this study were to describe the evaluation process and to examine the movement of drug...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-016-0437-5
更新日期:2016-12-01 00:00:00
abstract::A systematic review of dementia cost-of-illness (COI) studies in the US and Canada was conducted to explore the policy-making relevance of these studies. MEDLINE, CINAHL, EconLit, AMED and the Cochrane Library were searched from inception to March 2010 for English-language COI articles. Content analysis was used to ex...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11539450-000000000-00000
更新日期:2011-02-01 00:00:00