The clinical and economic impact of three-monthly long-acting formulation of paliperidone palmitate versus the one-monthly formulation in the treatment of schizophrenia in France: A cost-utility study.
Adult
Antipsychotic Agents
/ administration & dosage
Cohort Studies
Cost Savings
Cost-Benefit Analysis
Delayed-Action Preparations
/ administration & dosage
Drug Administration Schedule
Drug Costs
Female
France
/ epidemiology
Humans
Male
Models, Economic
Paliperidone Palmitate
/ administration & dosage
Quality-Adjusted Life Years
Recurrence
Schizophrenia
/ drug therapy
Antipsychotic therapy
Cost-effectiveness analysis
France
Paliperidone palmitate
Schizophrenia
Journal
L'Encephale
ISSN: 0013-7006
Titre abrégé: Encephale
Pays: France
ID NLM: 7505643
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
06
08
2018
revised:
24
02
2019
accepted:
11
03
2019
pubmed:
23
9
2019
medline:
19
5
2020
entrez:
23
9
2019
Statut:
ppublish
Résumé
Schizophrenia entails a considerable humanistic and economic burden. Improved treatment continuity to antipsychotic therapy is paramount to reduce the risk of relapse. The novel three-monthly paliperidone palmitate treatment (PP3M) offers the longest dosing interval currently available in France. This study assesses its cost-effectiveness, versus the currently available one-monthly long-acting treatment (PP1M) in French schizophrenic patients. A Markov model with monthly cycles was developed and adapted. It encompassed [a] administration of PP3M or PP1M in first-line, [b] a period where the patient does not receive any active treatment, and [c] a follow-up treatment line consisting of a treatment mix reflecting French clinical practice. Relapse rates in first-line were based on a pivotal non-inferiority head-to-head trial, and treatment discontinuation rates were based on French real-world data. Accounting for differences in drug exposure, time-dependent monthly relapse rates were applied following discontinuation to first line. The impact of a less frequent injection schedule for PP3M in QoL was accounted for through the application of a utility differential. The collective perspective was adopted throughout a 5-year time horizon. Four percent discount rates were applied on costs and outcomes. PP3M was dominant when compared to PP1M, featuring an incremental QALY of 0.123 and a cost saving effect (-669€) resulting from reduced therapy costs (drug acquisition, administration and monitoring) and relapse-related costs. Sensitivity analysis supported the robustness of the results. With slightly better QALY outcomes and a cost-saving effect when compared to PP1M, introducing PP3M is an improvement to the current treatment in France.
Identifiants
pubmed: 31542210
pii: S0013-7006(19)30088-0
doi: 10.1016/j.encep.2019.03.001
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Delayed-Action Preparations
0
Paliperidone Palmitate
R8P8USM8FR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
459-467Informations de copyright
Copyright © 2019. Published by Elsevier Masson SAS.