Quality-adjusted life year difference in patients with predominant negative symptoms of schizophrenia treated with cariprazine and risperidone

Abstract

Aim:Our study aimed at estimating differences in quality-adjusted life year (QALY) gain for patients with predominant negative symptoms of schizophrenia treated with cariprazine compared with risperidone. Materials & methods:A Markov model was built, based on the Mohr-Lenert approach and data derived from clinical trials, to estimate potential QALY gains of patients. Results: Patients had higher probability of reaching better health states treated with cariprazine compared with risperidone. In the model, this resulted in an estimated QALY gain of 0.029 per patient, after 1 year of treatment. Conclusion: Cariprazine, which showed clinically meaningful improvement in the symptoms, and personal and social performance, can also provide significant QALY gain in the treatment of patients with predominant negative symptoms of schizophrenia compared with risperidone.

The role of dopamine D3receptors in the mechanism of action of cariprazine

“…10 Cariprazine showed a significant effect on primary negative symptoms after 14 weeks of treatment and continued to improve until the endpoint, at week 26. The reduction of the Positive and Negative Syndrome Scale factor score for negative symptoms (PANSS-FSNS) was paralleled by a greater improvement in functioning (self-care, interpersonal relationship, and social activities), with a consequent increase in the quality of life 60 as previously shown for aripiprazole but not with paliperidone 9 emphasizing the added value of the partial agonism activity.…”

Cariprazine for acute and maintenance treatment of adults with schizophrenia: an evidence-based review and place in therapy

“…Quality-adjusted life-year gain was also modeled, and resulted in an estimated quality-adjusted life-year gain of 0.029 per patient after 1 year of treatment. 28 The most common adverse event for cariprazine was akathisia (8%), which was also observed for 5% of persons randomized to risperidone.…”

“…Other sources of information included product labeling 10 and the author’s prior published reviews. 11 – 13 Searching for “cariprazine” using PubMed yielded 125 records, of which 15 were original reports of clinical trial data in persons with schizophrenia, 14 – 28 24 were medicinal chemistry or preclinical research reports, 29 – 52 9 were original reports of cariprazine clinical trial data for disorders other than schizophrenia, 53 – 61 and the remainder consisted of reviews, commentaries, or articles that did not appear directly relevant. Three meta-analyses were found that focused on cariprazine and included data for the treatment of schizophrenia.…”

Using informative prior based on expert opinion in Bayesian estimation of the transition probability matrix in Markov modelling—an example from the cost-effectiveness analysis of the treatment of patients with predominantly negative symptoms of schizophrenia with cariprazine

“…The cost-effectiveness model has been described elsewhere ( Fig. 1) [9]. Briefly, a Markov cohort model was built in Microsoft Excel with eight health states for schizophrenia (hereinafter referred to as the Mohr-Lenert health states) defined by Mohr et al in 2004 and a death state [10].…”

“…Informative priors based on expert opinions might be more appropriate than vague priors. found in a concise format in Table 2 of the paper presenting the cost-effectiveness model [9]. As the pivotal clinical trial in which the model was based on provided no data on mortality, as there were not any participants who died during the study period, the age-and sex-specific mortality rates of the general population were used in the model, and no difference in the mortality between the two treatment groups was assumed [11].…”