Title: Comparative cost-effectiveness of 11 oral antipsychotics for relapse prevention in schizophrenia within Singapore using effectiveness estimates from a network meta-analysis
year: 2016
Journal: Int Clin Psychopharmacol
Volume: 31
Issue: 2
Pages: 84-92
Epubdate: 01/12/2015
date: Mar
Alternate Journal: International clinical psychopharmacology
ISSN: 0268-1315
Article Number: 26619182
Keywords: Administration, Oral Adult Antipsychotic Agents/*administration & dosage/adverse effects/*economics Cost-Benefit Analysis *Drug Costs Female Humans Male Markov Chains Middle Aged Models, Economic Quality of Life Quality-Adjusted Life Years Recurrence Schizophrenia/diagnosis/*drug therapy/*economics *Schizophrenic Psychology Singapore Time Factors Treatment Outcome Young Adult
Abstract: This study modelled the cost-effectiveness of 11 oral antipsychotics for relapse prevention among patients with remitted schizophrenia in Singapore. A network meta-analysis determined the relative efficacy and tolerability of 11 oral antipsychotics (amisulpride, aripiprazole, chlorpromazine, haloperidol, olanzapine, paliperidone, quetiapine, risperidone, sulpiride, trifluoperazine and ziprasidone). The clinical estimates were applied in a Markov model to estimate lifetime costs and quality-adjusted life-years gained. Quality-of-life data were obtained from published literature. Resource utilization and cost data were retrieved from local hospital databases. The annual direct cost of healthcare services for a patient experiencing a relapse episode was three-fold that of a patient not in relapse of schizophrenia. The most favourable pharmacological treatment for relapse prevention was olanzapine with an annual probability of relapse of 0.24 (0.13-0.38) with placebo as a reference of 0.75 (0.73-0.78). Olanzapine emerged as the dominant treatment with the highest quality-adjusted life-years gained and lowest lifetime costs. Ziprasidone, aripiprazole and paliperidone incurred higher lifetime costs compared with no treatment. Probability and cost of relapse were key drivers of cost-effectiveness in sensitivity analyses. The data can help prescribers in choosing appropriate treatment and payers in allocating resources for the clinical management of this serious psychiatric disorder.
Notes: 1473-5857 Lin, Liang Zhao, Ying J Zhou, Hui J Khoo, Ai L Teng, Monica Soh, Lay B Lim, Boon P Sim, Kang Journal Article Meta-Analysis England Int Clin Psychopharmacol. 2016 Mar;31(2):84-92. doi: 10.1097/YIC.0000000000000111.
URI: https://open-access.imh.com.sg/handle/123456789/5057
Authors Address: aPharmacy and Therapeutics Office, Group Corporate Development, National Healthcare Group Departments of bPharmacy cGeneral Psychiatry, Institute of Mental Health, Singapore, Singapore.
Database Provider: NLM
language: eng
Appears in Collections:2016

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