Abstract:
BACKGROUND:Treatment with antipsychotic medication is an important element of relapse prevention in the management of schizophrenia, and can reduce inpatient stays. Recently, the long-acting atypical antipsychotic paliperidone long-acting injectable (PLAI), a once-monthly LAI antipsychotic, was approved for treatment of schizophrenia in Germany.
OBJECTIVE:To estimate, based on a previously published model, the cost effectiveness of PLAI compared with other common antipsychotic treatment strategies in patients diagnosed with schizophrenia in Germany.
METHODS:A Markov decision analytic model was adapted to the German healthcare system. The model considers the cost effectiveness for PLAI as a maintenance treatment for patients with schizophrenia from the payer perspective. The patients transition between eight health states on a monthly basis over a 5-year time horizon. As therapeutic strategies, PLAI, quetiapine, risperidone long-acting injections (RLAI), oral olanzapine, oral risperidone, zuclopenthixol decanoate, olanzapine long-acting injections (OLAI), oral typical and oral atypical were compared. Probability of relapse, level of adherence, side effects and treatment discontinuation were derived from the Swedish original model. Input factors regarding resource use and costs were estimated and adjusted for the German healthcare system. A probabilistic sensitivity analyses (PSA) using cost-effectiveness scatter plots was performed to visualize the robustness of the results.
RESULTS:In base-case scenario, PLAI is superior to RLAI in gained quality-adjusted life-years (QALYs) and avoided relapses. Relative to all other treatment strategies, PLAI is more effective with regard to gained QALYs and avoided relapses but results in higher treatment costs over a 5-year horizon in base-case scenario. The results were tested in PSA. If a cost-effectiveness threshold of
journal_name
Appl Health Econ Health Policyjournal_title
Applied health economics and health policyauthors
Zeidler J,Mahlich J,Greiner W,Heres Sdoi
10.1007/s40258-013-0050-0subject
Has Abstractpub_date
2013-10-01 00:00:00pages
509-21issue
5eissn
1175-5652issn
1179-1896journal_volume
11pub_type
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journal_title:Applied health economics and health policy
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更新日期:2015-02-01 00:00:00
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journal_title:Applied health economics and health policy
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,随机对照试验
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journal_title:Applied health economics and health policy
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journal_title:Applied health economics and health policy
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doi:10.2165/00148365-200605030-00002
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,随机对照试验
doi:10.2165/11592220-000000000-00000
更新日期:2011-07-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Applied health economics and health policy
pub_type: 杂志文章,评审
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更新日期:2013-02-01 00:00:00