Cost-effectiveness of asenapine in the treatment of schizophrenia in Canada

Lachaine, J.; Beauchemin, C.; Mathurin, K.; Gilbert, Dominique; Beillat, Maud

doi:10.3111/13696998.2014.897627

Cited by 9 publications

(13 citation statements)

References 49 publications

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“…The characteristics of the included studies were summarized in Table 1 . The studies covered the regions of Europe ( 15 , 18 , 21 , 23 – 28 , 32 , 34 – 36 , 39 ), North America ( 16 , 17 , 31 ), Asia ( 19 , 22 , 29 , 30 , 33 , 37 , 38 ), and Africa ( 20 ). Eleven (44%) ( 16 , 17 , 19 – 22 , 29 , 32 , 36 , 37 , 39 ) of the 25 studies specified the onset or averaged ages of patients and four studies (16%) ( 15 , 18 , 23 , 24 ) focused on patients in acute or relapsed states.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia

Wang

Shi

Guan

et al. 2021

Front. Public Health

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Background: Schizophrenia is a severe and complex disease with substantial economic and social burdens. Despite multiple treatment choices, adverse events, and impaired social functions are still challenges in clinical therapy. Pharmacoeconomic evaluations could provide evidence to help decision makers improve the utilization of scarce resources. However, there remains some challenges especially in modeling due to uncertainties in progression of schizophrenia. There are limited summaries about the overall methodologies of schizophrenia economic evaluations.Objective: The aim of this study is to review the existing economic evaluations of antipsychotics for the treatment of schizophrenia and summarize the evidence and methods applied.Methods: An electronic literature search was performed in PubMed, Web of Science, EBSCO host, The Cochrane Library and ScienceDirect from January 2014 to December 2020. Search terms included “schizophrenia,” “schizophrenic,” “pharmacoeconomic,” “economic evaluation,” “cost-effectiveness,” and “cost-utility.” The Literature was screened and extracted by two researchers independently and assessed with the Quality of Health Economic Studies (QHES) List and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement.Results: A total of 25 studies were included in the review. The regions included Europe, North America, Asia and Africa. Most of the studies chose second-generation antipsychotics as comparators and integrated treatment sequences. Time horizons varied from 1 year to lifetime. The healthcare sector was the most common perspective, accordingly, most of the evaluations considered only direct medical costs. The Markov model and decision tree model were the most common choices. Adverse events, compliance and persistence were considered important parameters. Quality-adjusted life-years were the major outcomes applied to the economic evaluations. All utilities for health states and adverse events were collected from published literature. All of the studies applied uncertainty analysis to explore the robustness of the results. The quality of the studies was generally satisfactory. However, improvements were needed in the choice of time horizons, the measurements of outcomes and the descriptions of assumptions.Conclusions: This study highlights the methodology of economic evaluation of schizophrenia. Recommendations for modeling method and future study are provided.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia

Wang

Shi

Guan

et al. 2021

Front. Public Health

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“…Increase in mortality due to adverse events (6/60, 10.0%). The adverse events which were assumed to increase patients’ mortality risk included diabetes (3/6, 50.0%) [ 35 , 46 , 47 ], cardiovascular disease (3/6, 50.0%) [ 58 – 60 ], weight gain (2/6, 33.3%) [ 48 , 49 ], agranulocytosis (1/6, 16.7%) [ 46 ], hypertension (1/6, 16.7%) [ 47 ] and stroke (1/6, 16.7%) [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…31, 16.1%) [41][42][43][44][45], five studies assumed antipsychotic medications increase patients' mortality risk (5/31, 16.1%) [35,36,[46][47][48], and one study assumed antipsychotic medications can both increase and reduce patients' mortality risk (1/31, 3.2%) [49]. In the six studies which assumed that antipsychotic medications can reduce patients' mortality risk, they assumed that patients taking antipsychotic medications are less likely to commit suicide and thus have lower mortality.…”

Section: Plos Onementioning

confidence: 99%

Systematic review of the methods of health economic models assessing antipsychotic medication for schizophrenia

et al. 2020

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Background Numerous economic models have assessed the cost-effectiveness of antipsychotic medications in schizophrenia. It is important to understand what key impacts of antipsychotic medications were considered in the existing models and limitations of existing models in order to inform the development of future models. Objectives This systematic review aims to identify which clinical benefits, clinical harms, costs and cost savings of antipsychotic medication have been considered by existing models, to assess quality of existing models and to suggest good practice recommendations for future economic models of antipsychotic medications. Methods An electronic search was performed on multiple databases (MEDLINE, EMBASE, PsycInfo, Cochrane database of systematic reviews, The NHS Economic Evaluation Database and Health Technology Assessment database) to identify economic models of 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. Key impacts of antipsychotic medications considered by exiting models were descriptively summarised. Results Sixty models were included. Existing models varied greatly in key impacts of antipsychotic medication included in the model, especially in clinical outcomes used for assessing reduction in psychotic symptoms and types of adverse events considered in the model. Quality of existing models was generally low due to failure to capture the health and cost impact of

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“…Some of the health states had utility values reported in a combination of the other type of states including adherence level, the antipsychotic treatment used, and state duration. Utility value for the health state of overall schizophrenia was considered in the studies which focused mainly on side effects of antipsychotic treatments [36,38].…”

Section: Health States Of Schizophrenia and The Associated Utility Vamentioning

confidence: 99%

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

Zhou

Millier

François

et al. 2019

Journal of Market Access & Health Policy

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Background and Objectives: Utility elicitation studies for schizophrenia generate different utility values for the same health states. We reviewed utility values used in schizophrenia pharmacoeconomic evaluations and evaluated the impact of their selection on the incremental costeffectiveness ratio (ICER). Methods: A systematic search was performed in Medline and Embase. Health state definitions, associated utility values, elicitation studies, and value selection processes were extracted. Sets of utility values for all schizophrenia health states were used in a cost-effectiveness model to evaluate the ICER. Results: Thirty-five cost-utility analyses (CUAs) referring to 11 utility elicitation studies were included. The most frequent health states were 'stable' (28 CUAs, 7 utility elicitation studies, 10 values, value range 0.650-0.919), 'relapse requiring hospitalisation' (18, 5, 7, 0.270-0.604), 'relapse not requiring hospitalisation' (18, 5, 10, 0.460-0.762), and 'relapse only' (10, 5, 6, 0.498-0.700). Seventeen sets of utility values were identified with difference in utility values between relapse and stable ranging from −0.358 to −0.050, resulting in ICERs ranging from −56.2% to +222.6% from average. Conclusion: The use of utility values for schizophrenia health states differs among CUAs and impacts on the ICER. More rigorous and transparent use of utility values and sensitivity analysis with different sets of utility values are suggested for future CUAs.

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Cost-effectiveness of asenapine in the treatment of schizophrenia in Canada

Abstract: Despite the short time horizon, the lack of compliance data and the assumptions made, this economic evaluation demonstrates that asenapine is a cost-effective strategy compared to olanzapine and to most of the atypical antipsychotics frequently used in Canada.

Cited by 9 publications

References 49 publications

A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia

A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia

Systematic review of the methods of health economic models assessing antipsychotic medication for schizophrenia

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

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