A Cost-effectiveness analysis of Antipsychotics for treatment of Schizophrenia in Uganda

Mutamba, Byamah B; Nganizi, Angelo; Babigumira, J.B.

doi:10.1016/j.jval.2015.03.710

Cited by 4 publications

(8 citation statements)

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“… 25 , 26 In Uganda, for example, there is limited availability of second-generation antipsychotics (SGA). 27 …”

Section: Discussionmentioning

confidence: 99%

“…Second, it might also not be possible to make slow increments because of the lack of formulations of antipsychotic medications available in low resource settings. 27 Finally, given the brief time frame of the study (admission to discharge), it is possible that the increments were made over a longer period. This study, therefore, needs replication by longitudinal studies to clearly define the dose adjustments over 2 years.…”

Section: Discussionmentioning

confidence: 99%

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Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

Mwesiga

Nakasujja

Nankaba

et al. 2021

South African Journal of Psychiatry

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Background: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear. Aim: To determine the quality of the individual and group level interventions provided to first episode psychosis patients in Uganda Setting: The study was performed at the only tertiary psychiatric hospital in Uganda. Methods: A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was performed. The proportion of participants who received different essential components for individual and group level interventions were calculated. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-episode psychosis services fidelity scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients who received the different components of the intervention. Twelve essential components across the individual and group interventions were assessed and their quality quantified. Results:The final sample included 156 first-episode psychosis patients. The median age was 27 years (inter-quartile range ) and 55% of the participants were female. All 12 essential components had poor quality with the range of scores on the FEPS-FS between one and three. Only one essential component assessed (use of single antipsychotics) had moderate quality. Conclusion:Amongst current services at the Butabika National Referral Mental Hospital in Uganda, the essential components for individual and group level interventions for psychotic disorders are of poor quality. Further studies are required on how the quality of these interventions can be improved.

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“… 25 , 26 In Uganda, for example, there is limited availability of second-generation antipsychotics (SGA). 27 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

Mwesiga

Nakasujja

Nankaba

et al. 2021

South African Journal of Psychiatry

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“…The results, reported in Table 3, show that for all three patient groups for whom data were available, the studies with no conflicts of interest reported inconsistent conclusions. For example, for studies which focused on schizophrenia patients in remission, two studies found oral risperidone was cost-effective compared to oral olanzapine [1,31], while three studies found oral olanzapine was cost-effective compared to oral risperidone [42,47,50].…”

Section: Conclusion For Antipsychoticsmentioning

confidence: 99%

“…Oral risperidone is cost-effective compared to oral olanzapine 2 [1,31] Oral olanzapine is cost-effective compared to oral risperidone 3 [42,47,50]…”

Section: Schizophrenia Patients In Remissionmentioning

confidence: 99%

A Systematic Review of Economic Models Across the Entire Schizophrenia Pathway

et al. 2020

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Background: Schizophrenia is associated with a high economic burden. Economic models can help to inform resource allocation decisions to maximise benefits to patients.Objectives: This systematic review aims to assess the availability, quality and consistency of conclusions of health economic models evaluating the cost-effectiveness of interventions for schizophrenia. Methods: An electronic search was performed on multiple databases (MEDLINE, EMBASE, PsycInfo, Cochrane database of systematic reviews, NHS Economic Evaluation Database and Health Technology Assessment database) to identify economic models of interventions for schizophrenia published between 2005-2020. Two independent reviewers selected studies for inclusion. Study quality was assessed using the National Institute for Health and Care Excellence (NICE) checklist and the Cooper hierarchy. Model characteristics and conclusions were descriptively summarised. Results: Seventy-three models met inclusion criteria. 78% of existing models assessed antipsychotics, however, due to inconsistent conclusions reported by different studies, no antipsychotic can be considered clearly costeffective compared with the others. A very limited number of models suggest that the following nonpharmacological interventions might be cost-effective: psychosocial interventions, stratified tests, employment intervention and intensive intervention to improve liaison between primary and secondary care. The quality of included models is generally low due to use of a short time horizon, omission of adverse events of interventions, poor data quality and potential conflicts of interest.Conclusions: This review highlights a lack of models for non-pharmacological interventions, and limitations of the existing models, including low quality and inconsistency in conclusions. Recommendations on future modelling approaches for schizophrenia are provided. Key Points for Decision Makers• This is the first systematic review of model-based economic analyses which covers the entire schizophrenia care pathway, by including any intervention for the prevention, detection, diagnosis, treatment and follow-up of schizophrenia.• This review highlights a lack of models for non-pharmacological interventions, and low quality of existing models. Common reasons for low-quality include use of a time-horizon which is not sufficiently long, failure to capture the health and cost impact of adverse events of the interventions under assessment, and potential conflicts of interest.• Due to inconsistent conclusions reported by different studies, no antipsychotic can be considered clearly cost-effective compared with the others. A very limited number of models suggest that the following non-pharmacological interventions might be cost-effective: psychosocial interventions, stratified tests, employment intervention and intensive intervention to improve liaison between primary and secondary care.• A consistent basis for the model structure, use of evidence and assumptions in health economic models is required in order to i...

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“…However, the majority of cost-effectiveness studies have a conflict of interests (funded by their manufacturers), are modelling studies not representing the real world, and have methodological limitations (Kayo & Razzouk, 2017). Moreover, there is a scarcity of cost-effectiveness studies in low and middle-income countries Lubinga et al, 2015). In this regard, economic evaluation can be useful for guiding decision making on how to allocate public financial resources to new technologies and drugs since decision makers take into account the impact of these new technologies/drugs costs to the health budget in terms of feasibility, sustainability, acceptability, coverage, population characteristics and health priority needs (Chisholm et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Cost variation of antipsychotics in the public health system in Brazil: the implication for health resource use

Razzouk¹

2017

JBES

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A Cost-effectiveness analysis of Antipsychotics for treatment of Schizophrenia in Uganda

Cited by 4 publications

References 0 publications

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

A Systematic Review of Economic Models Across the Entire Schizophrenia Pathway

Cost variation of antipsychotics in the public health system in Brazil: the implication for health resource use

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