Economic analysis of paliperidone long-acting injectable for chronic schizophrenia in Portugal

Einarson, Thomas R.; Maia-Lopes, Susana; Goswami, Pushpendra; Bereza, Basil G; Impe, K. Van

doi:10.1080/13696998.2016.1184156

Cited by 18 publications

(12 citation statements)

References 63 publications

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“…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. Second-generation antipsychotics (SGAs) also known as atypical antipsychotics were the most common interventions chosen in the analyses, where seven studies (28%) ( 15 , 18 , 21 , 24 , 25 , 27 , 30 ) compared the cost-effectiveness of long-acting-injections (LAIs). Eight studies (32%) ( 18 – 22 , 25 , 28 , 39 ) included both first-generation and second-generation antipsychotics as compared interventions where haloperidol was the commonest ( n = 7, 87.5%).…”

Section: Resultsmentioning

confidence: 99%

“…Second-generation antipsychotics (SGAs) also known as atypical antipsychotics were the most common interventions chosen in the analyses, where seven studies (28%) ( 15 , 18 , 21 , 24 , 25 , 27 , 30 ) compared the cost-effectiveness of long-acting-injections (LAIs). Eight studies (32%) ( 18 – 22 , 25 , 28 , 39 ) included both first-generation and second-generation antipsychotics as compared interventions where haloperidol was the commonest ( n = 7, 87.5%). 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).…”

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.…”

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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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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Nanomedicines - Tiny particles and big challenges

Marques

Choo

Ashtikar

et al. 2019

Advanced Drug Delivery Reviews

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Economic analysis of paliperidone long-acting injectable for chronic schizophrenia in Portugal

Abstract: In Portugal, PP-LAI dominated HAL-LAI and RIS-LAI and was cost-effective over oral-OLZ with respect to QALYs gained, relapses avoided, and hospitalizations avoided.

Cited by 18 publications

References 63 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

A Systematic Review of Economic Models Across the Entire Schizophrenia Pathway

Nanomedicines - Tiny particles and big challenges

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