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.


Journal

L'Encephale
ISSN: 0013-7006
Titre abrégé: Encephale
Pays: France
ID NLM: 7505643

Informations de publication

Date de publication:
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

459-467

Informations de copyright

Copyright © 2019. Published by Elsevier Masson SAS.

Auteurs

C H Arteaga Duarte (CH)

IQVIA, Corporate Village, Davos Building, Da Vincilaan 7, 1930 Zaventem, Belgium. Electronic address: carch55@yahoo.fr.

E Fakra (E)

Department of Psychiatry, University Hospital of Saint-Etienne, TAPE Laboratory, EA7423, Jean Monnet University, 42100 Saint-Étienne, France. Electronic address: eric.fakra@chu-st-etienne.fr.

C Van Gils (C)

IQVIA, Corporate Village, Davos Building, Da Vincilaan 7, 1930 Zaventem, Belgium.

P Guillon (P)

Janssen-Cilag, Rue Camille Desmoulins 1, TSA 91003, 92787 Issy-les-Moulineaux, France.

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Classifications MeSH