Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States

Furiak, Nicolas M; Ascher-Svanum, Haya; Klein, Robert W.; Smolen, Lee; Lawson, Anthony H.; Conley, Robert R.; Culler, Steven D.

doi:10.1186/1478-7547-7-4

Cited by 40 publications

(103 citation statements)

References 95 publications

(139 reference statements)

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“…The other models adapted the model of Furiak et al [75]. , with minor changes to the model structure (adding 2 side effects: hyperprolactinaemia and tardive dyskinesia).…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of pharmacoeconomic models for schizophrenia

Zhou

Millier

Toumi

2018

Journal of Market Access & Health Policy

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Background: Economic models are broadly used in the economic evaluation of antipsychotics in schizophrenia. Our objective was to summarize the structure of these models.Methods: Model-based economic evaluations of antipsychotics in schizophrenia were identified through Medline and Embase. General information was extracted including analysis type, model type, perspective, population, comparator, outcome, and timeframe. Model-specific structures for decision tree (DT), cohort- and patient-level Markov model (CLMM, PLMM), and discrete-event simulation (DES) models were extracted.Results: A screen of 1870 records identified 79 studies. These were mostly cost-utility analyses (n = 48) with CLMM (n = 32) or DT models (n = 29). They mostly applied payer perspective (n = 68), focused on general schizophrenia for relapse prevention (n = 73), compared pharmacotherapies as first-line (n = 71), and evaluated incremental cost per quality-adjusted life year (QALY) gained (n = 40) with a 1-year (n = 32) or 5-year (n = 26) projection. DT models progressed with the branching points of response, relapse, discontinuation, and adherence. CLMM models transitioned between disease states, whereas PLMM models transitioned between adverse event states with/without disease state. DES models moved forward with times to remission, relapse, psychiatrist visit, and death.Conclusions: A pattern of pharmacoeconomic models for schizophrenia was identified. More subtle structures and patient-level models are suggested for a future modelling exercise.

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“…The other models adapted the model of Furiak et al [75]. , with minor changes to the model structure (adding 2 side effects: hyperprolactinaemia and tardive dyskinesia).…”

Section: Resultsmentioning

confidence: 99%

“…They set the baseline body weight and body mass index to patients individually, and simulated the changes in body weight and possible adverse events (AE). The model of Furiak et al [75]. had 3 health states (stable with or without side effects, and relapse requiring hospitalization) and 3 adherence levels, with a cycle length of 3 months.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of pharmacoeconomic models for schizophrenia

Zhou

Millier

Toumi

2018

Journal of Market Access & Health Policy

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“…The 24 studies included represent data from 14 countries: eight articles from the USA Tunis et al, 2006;Bounthavong & Okamoto, 2007;Edwards et al, 2008;Furiak et al, 2009;Ascher-Svanum et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013), two from Canada (Cooper et al, 2008;Mcintyre et al, 2010) and Spain (Garcia-Ruiz et al, 2012;Treur et al, 2012) and one from Slovenia (Obradovic et al, 2007), Italy (Colombo et al, 2008), Greece (Geitona et al, 2008), Belgium (De Ridder & De Graeve, 2009), Brazil (Lindner et al, 2009), Mexico (Mould-Quevedo et al, 2009, China (Yang et al, 2009), Norway (Kim & Aas, 2011), Sweden (Lindström et al, 2011), Germany (Zeidler et al, 2013) and Vietnam (Anh et al, 2015). One study evaluated the cost-effectiveness of antipsychotics in European countries .…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…A utility component was found in 13 included studies, 12 of them reported effectiveness in measures of QALYs Knapp et al, 2008;De Ridder & De Graeve, 2009;Furiak et al, 2009;Lindner et al, 2009;Mcintyre et al, 2010;Ascher-Svanum et al, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;Garcia-Ruiz et al, 2012;Treur et al, 2012;Zeidler et al, 2013) and one of them in DALYs averted (Anh et al, 2015). Regarding the source of data and modeling, three studies were based on Randomized Clinical Trials (RCTs) Tunis et al, 2006;Ascher-Svanum et al, 2011), three studies analyzed data from observational studies (Cooper et al, 2008;Knapp et al, 2008;De Ridder & De Graeve, 2009), nine studies built Markov models with literature data (Lindner et al, 2009;Mould-Quevedo et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013;Zeidler et al, 2013;Anh et al, 2015) and nine studies only reported a decision analysis model with literature data (Bounthavong & Okamoto, 2007;Obradovic et al, 2007;Colombo et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Furiak et al, 2009;Yang et al, 2009;Garcia-Ruiz et al, 2012;Treur et al, 2012). Most studies adopted time horizons of one year (Tunis et al, ...…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Regarding the source of data and modeling, three studies were based on Randomized Clinical Trials (RCTs) Tunis et al, 2006;Ascher-Svanum et al, 2011), three studies analyzed data from observational studies (Cooper et al, 2008;Knapp et al, 2008;De Ridder & De Graeve, 2009), nine studies built Markov models with literature data (Lindner et al, 2009;Mould-Quevedo et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013;Zeidler et al, 2013;Anh et al, 2015) and nine studies only reported a decision analysis model with literature data (Bounthavong & Okamoto, 2007;Obradovic et al, 2007;Colombo et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Furiak et al, 2009;Yang et al, 2009;Garcia-Ruiz et al, 2012;Treur et al, 2012). Most studies adopted time horizons of one year (Tunis et al, 2006;Obradovic et al, 2007;Cooper et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Knapp et al, 2008;Furiak et al, 2009;Mould-Quevedo et al, 2009;Ascher-Svanum et al, 2011;Garcia-Ruiz et al, 2012) and five years (Colombo et al, 2008;Lindner et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Santos¹,

Godói²,

Vidal³

et al. 2017

JBES

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Objective: The aim of this study is to conduct a systematic review on cost-effectiveness analysis of oral antipsychotic agents to identify the trend of cost-effectiveness of drugs available for the treatment of schizophrenia. Methods: A search was conducted in three databases (MEDLINE, LILACS and PsycINFO) for head-to-head economic comparisons of antipsychotic agents. A manual search in journals, dissertations and theses databases, congresses abstracts and the Cochrane Library was also conducted to ensure comprehensiveness. After evaluation by independent reviewers, complete economic evaluations of oral antipsychotic medications were included in the final analysis. Results: Twenty four studies were included in the final analysis. The trend observed in the pooled studies showed that risperidone, olanzapine and clozapine were the most cost-effective drugs included to treat schizophrenia. Aripiprazole and haloperidol were considered comparable to quetiapine or ziprasidone and less cost-effective than olanzapine and risperidone in the pooled analysis. After removal of comparisons that had sponsored drugs included, risperidone, olanzapine and clozapine were still considered the most cost-effective strategies to treat schizophrenia. The analysis of only cost-utility studies shows approximately the same results of the other analysis. Conclusions: An analysis that consider first-vs. second-generation antipsychotics polled together might be biased by the different profiles of the specific drugs, not considering the heterogeneity of the group of second-generation antipsychotics. There seems to be a difference in the cost-effectiveness profiles between specific antipsychotic drugs. Risperidone, olanzapine and clozapine seem to be the drugs most considered cost-effective to treat schizophrenia. This result was robust to changes in funding. RESUMOObjetivo: O objetivo deste estudo é conduzir uma revisão sistemática de custo-efetividade de antipsicóticos orais para identificar uma tendência de custo-efetividade dos medicamentos disponí-veis para o tratamento da esquizofrenia. Métodos: Uma busca eletrônica foi realizada nas bases de dados Medline (via PubMed), Lilacs (via VS) e PsycINFO para avaliações econômicas comparando head-to-head medicamentos antipsicóticos para esquizofrenia. Uma busca manual complementar foi realizada para garantir abrangência. Resultados: Depois da avaliação por revisores independen- tes, 24 avaliações econômicas completas de antipsicóticos orais para esquizofrenia foram incluí-das na análise final. A tendência observada no conjunto dos estudos mostrou que a risperidona, a olanzapina e a clozapina foram mais comumente consideradas os medicamentos mais custo--efetivos para esquizofrenia. Aripiprazol e olanzapina foram considerados comparáveis a quetiapina ou ziprasidona e menos custo-efetivos, no geral, que olanzapina e risperidona. Após a remoção das comparações que incluíam medicamentos dos patrocinadores dos estudos, a mesma tendência foi observada. A análise apenas de estudos de custo-utili...

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Health Outcomes Among Patients Diagnosed with Schizophrenia in the US Veterans Health Administration Population Who Transitioned from Once-Monthly to Once-Every-3-Month Paliperidone Palmitate: An Observational Retrospective Analysis

et al. 2019

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Introduction: There is limited literature on treatment patterns, healthcare resource utilization (HRU), and costs among patients who transition from once-monthly paliperidone palmitate (PP1M) to once-every-3-month paliperidone palmitate (PP3M) in a real-world setting. Hence, this study compared treatment patterns, HRU, and costs 12-month pre-and post-PP3M transition among Veteran's Health Administration (VHA) patients with schizophrenia. Methods: Patients with schizophrenia (aged C 18 years) who initiated PP1M and transitioned per on-label criteria to PP3M (no treatment gap of [ 45 days in PP1M during the 4 months prior, same dose strength of the last two PP1M claims, and appropriate dose conversion from last PP1M to first PP3M claim) from January 2015 to March 2017 were included from the VHA database. The first transition date to PP3M was identified as the index date. Patients were required to have 12-month pre-and post-PP3M continuous health plan eligibility. Outcomes were compared using the Wilcoxon-signed rank and McNemar's test, appropriately. Results: The study included 122 patients [mean (SD) age: 54 (13.7) years]. Pre-and post-PP3M transition, 64.8% and 61.5% of patients were adherent (proportion of days covered C 80%) to PP1M and PP3M, respectively. Comparison of HRU outcomes pre-and post-PP3M transition exhibited lower all-cause outpatient (37.5 vs. 31.1, p \ 0.0001) and pharmacy visits (56.1 vs. 46.7, p \ 0.0001). Similar trends were seen for mental health and schizophrenia-related outpatient and pharmacy HRU. Comparison of cost outcomes resulted in lower all-cause outpatient

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Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States

Cited by 40 publications

References 95 publications

Systematic review of pharmacoeconomic models for schizophrenia

Systematic review of pharmacoeconomic models for schizophrenia

Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Health Outcomes Among Patients Diagnosed with Schizophrenia in the US Veterans Health Administration Population Who Transitioned from Once-Monthly to Once-Every-3-Month Paliperidone Palmitate: An Observational Retrospective Analysis

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