PMH38 Cost-Effectiveness of Asenapine in the Treatment of Schizophrenia in Canada

Abstract

OBJECTIVES: Major Depressive Disorder (MDD) is an important and growing health problem in Turkey. Inclusion of a new drug in the positive list for its treatment requires the proof of cost effectiveness. The objective of this study was to assess the cost effectiveness of Agomelatine versus Venlafaxine and Duloxetine in treatment of MDD in Turkey. The study was undertaken from the payer perspective. METHODS: A discrete event model, already validated by European health authorities was used to compare Agomelatine with Venlafaxine and Duloxetine. An indirect comparison was made between Agomelatine and Duloxetine. In order to reflect the real clinical practice, the model defined 3-6 months of treatment, however the maintenance phase, defined as the recommended time to prevent eventual recurrences, was modeled longer (12 weeks and 24 weeks).The clinical outcome was measured as life years in remission. All direct costs for the year 2011 were taken into account. Costs and benefits were discounted by 3% and robustness of the results were tested by Monte Carlo simulation. RESULTS: Incremental Cost Effectiveness Ratios(ICER) were calculated and results were displayed as cost per additional life year in remission. The ICER was calculated as -18,799 TL/year in remission for Agomelatine versus Venlafaxine and -27,453 TL/year in remission for Agomelatine versus Duloxetine. CONCLUSIONS: Agomelatine dominated Venlafaxine and Duloxetine in treatment of MDD in Turkey. Sensitivity analyses revealed that the results were robust.

Economic evaluations on the use of aripiprazole for patients with schizophrenia: A systematic review

“…The data on economic evaluation were extracted on a spreadsheet preformatted in Microsoft Excel® by two independent authors (ICBH and TML), and any disagreement was resolved by a third author (PMA). The following data were extracted type of economic evaluation, type of population, country, payer's perspectives, reference [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] which fully met the eligibility criteria were selected for this systematic review (Figure 1).…”

“…Most of the studies have not established an age group of the target population, and four studies have focused on adult patients. 14,[19][20][21] In addition, none of the studies have established the definition of the age groups (eg 30-50 years). Eight studies specified the phase at which the patients with schizophrenia entered the study (eg remission, acute phase, right after the failure of antipsychotic therapy, hospitalization), [14][15][16][17]21,[28][29][30] and only one study has specified the onset age of the disease.…”

“…Eight studies specified the phase at which the patients with schizophrenia entered the study (eg remission, acute phase, right after the failure of antipsychotic therapy, hospitalization), [14][15][16][17]21,[28][29][30] and only one study has specified the onset age of the disease. 19 Most studies used data from the clinical trials sponsored by them, 14,15,17,18,[20][21][22]24 although some also partially used observational studies and real-life data in their economic model. 15,16,20,21,25,27 Nevertheless, none of them have used real-world data to measure the antipsychotics' efficacy and safety.…”

“…Regarding the type of economic evaluation, eight studies performed cost-utility analysis, 16,19,22,24,[26][27][28] five studies performed cost-effectiveness, 18,20,21,29,30 and four performed both the analyses. 14,15,17,25 Notably, 15 of the 17 studies were funded by the pharmaceutical industry.…”

“…14,15,17,25 Notably, 15 of the 17 studies were funded by the pharmaceutical industry. 14,15,[17][18][19][20][21][22][23][24][25][26][27][28][29] Of the remaining studies, one has declared no funding, 30 and one has not reported any funding issue. 16 The time horizon of the studies ranged from one year 17,18,23,24,27,29,30 to a lifelong duration.…”