Cost-effectiveness of olanzapine in the first-line treatment of schizophrenia in China

Zhao, Jingping; Jiang, Kaida; Li, Qingwei; Zhang, Yanlei; Cheng, Yan; Lin, Zhidan; Xuan, Jianwei

doi:10.1080/13696998.2019.1580714

Cited by 18 publications

(15 citation statements)

References 24 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%

“…Most of the studies measured the outcomes using quality-adjusted life-years (QALYs) ( n = 23, 92%), while only 2 studies (8%) ( 19 , 20 ) applied disability-adjusted life-years (DALYs). In addition, nine studies ( 18 , 21 , 24 , 25 , 27 , 28 , 30 , 31 , 33 ) reported both utility and clinical effects, where yearly relapse or relapse avoidance was the most frequent choice.…”

Section: Resultsmentioning

confidence: 99%

“…Due to the diverse efficacy and low compliance rate, therapeutic changes are common among schizophrenia patients, which makes treatment sequences worth consideration. Nineteen studies (76%) ( 15 – 18 , 20 – 25 , 27 – 31 , 33 , 35 , 36 , 38 ) specified treatment sequences in the models ( Table 2 ). The methods of setting second-line medications were flexible, including changing to drugs that differed from the first-line or applying mixed therapies based on market share ( 22 , 30 , 36 ) or simple averaging ( 22 , 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the eight studies (32%) choosing the health care sector perspective ( 15 , 17 – 19 , 22 , 24 , 25 , 27 ), seven studies adapted direct medical costs, while one study ( 15 ) included indirect costs which is inconsistent with the perspective. The payer perspective was chosen by 13 studies (52%) ( 21 , 23 , 28 , 30 – 39 ) where six studies specified costs paid by payers and seven studies ( 28 , 31 , 33 , 35 – 38 ) merely included direct medical costs. Among the 3 (14.3%) societal perspective-studies ( 20 , 26 , 29 ), only 1 study ( 20 ) took both direct and indirect costs into account, indicating that some confusion existed in distinguishing perspectives.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the Markov models consisted of a series of health states, which represent treatment sequences, disease progression or related adverse events and were connected by probabilities based on the averaged cohort level ( 27 ). Microsimulation models ( 18 , 33 , 38 , 39 ) are more flexible and natural for simulating clinical reality by incorporating patient-level characteristics. Due to the differentiation in the choice of therapy and the treatment effect among patients, a patient-level simulation model as well as a Markov model incorporating treatment sequences, relapse, remission, adherence and adverse events could be more suitable for clinical practice.…”

Section: Resultsmentioning

confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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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Open‐Label, Randomized, Single‐Dose, 2‐Period, 2‐Sequence Crossover, Comparative Pharmacokinetic Study to Evaluate Bioequivalence of 2 Oral Formulations of Olanzapine Under Fasting and Fed Conditions

Liu

et al. 2019

Clinical Pharm in Drug Dev

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Olanzapine, a second‐generation atypical antipsychotic drug, is widely used for schizophrenia and moderate to severe mania associated with bipolar disorders. This open‐label, randomized, single‐dose, 2‐sequence, 2‐period crossover, comparative pharmacokinetic study assessed the bioequivalence of 5 mg of olanzapine administered in tablet (R) or disintegrating tablet (T) formulation in healthy Chinese volunteers under both fasting and fed conditions. Numbers of enrolled subjects were 30 and 24 for fasting and fed treatments, respectively. Blood samples were drawn and collected predose as well as up to 144 hours postdose. The plasma concentration of olanzapine was quantitated by a robust, rapid, and sensitive liquid chromatography–tandem mass spectrometry method. The R was bioequivalent to T formulation under either fasting or fed conditions. The 90%CI for ratios of the geometric means observed maximum plasma concentration, area under the curve from time 0 extrapolated to last time point, and area under the curve from time 0 extrapolated to infinity were all within the allowed limit (80.0% to 125.0%). The pharmacokinetic profiles of T and R formulations were similar under fasting and fed conditions. Both formulations were well tolerated, with a similar incidence of treatment‐emergent adverse events under fasting and fed conditions.

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Pharmacoeconomics

Dodel

Kruse²,

Conrads-Frank³

et al. 2022

NeuroPsychopharmacotherapy

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Cost-effectiveness of olanzapine in the first-line treatment of schizophrenia in China

Cited by 18 publications

References 24 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

Open‐Label, Randomized, Single‐Dose, 2‐Period, 2‐Sequence Crossover, Comparative Pharmacokinetic Study to Evaluate Bioequivalence of 2 Oral Formulations of Olanzapine Under Fasting and Fed Conditions

Pharmacoeconomics

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