Cost-effectiveness of olanzapine long-acting injection in the treatment of patients with schizophrenia in the United States: a micro-simulation economic decision model

Abstract

This micro-simulation model finds the olanzapine-LAI treatment strategy to result in better effectiveness and to be a cost-effective alternative compared to oral olanzapine and the LAI formulations of risperidone, paliperidone, and haloperidol in the treatment of non-adherent and partially adherent patients with schizophrenia in the United States. A key limitation is the assumption how LAI therapies compare to oral counterparts due to sparse head-to-head data. Further research is needed to verify baseline assumptions.

Strengths, weaknesses, opportunities and challenges for long acting injectable therapies: Insights for applications in HIV therapy

“…Both of these medicines are based upon the same nanotechnology that generates solid drug nanoparticle (SDN) suspensions via the process of wet bead milling (also known as nanomilling; see also section 4.1. below). LA injectable formulations have previously been developed and licensed for other indications such as contraception and schizophrenia (Table 1) [9-11]. The advent of the HIV LA medicines has been greeted with great excitement within the scientific, clinical and patient communities.…”

Early aggressive intervention with tocilizumab for rheumatoid arthritis increases remission rate defined using a Boolean approach in clinical practice

“…However, comparing the two is difficult in clinical practice. One reason is that levels of acutephase reactants such as CRP are improved with tocilizumab treatment compared with treatment with anti-TNF-a agents [19]. Based on the definition of remission using a Boolean approach, CRP B1 should be achieved in most cases involving tocilizumab treatment.…”

The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving

“…This is the first economic evaluation of paliperidone palmitate to our knowledge. Previous economic models evaluating atypical anti-psychotics (i) have included different comparators [22][23][24][25][42][43][44] ; (ii) have evaluated a different patient population [45][46][47] ; (iii) have extrapolated results over long time horizons 47 ; and (iv) have typically used preference-based end-points (e.g., QALYs) as the primary end-point 47 , rather than objective clinical measures such as days of relapse averted.…”

“…The decision analytic modeling techniques developed by Glazer and Ereshefsky were subsequently employed to ascertain the benefit of two longacting atypical anti-psychotics, LAI risperidone 22,23 , and, more recently, LAI olanzapine 24,25 . Here, we used those same techniques, along with updated, improved comparative clinical and cost data, to assess paliperidone palmitate.…”