Cost analysis of lurasidone for the treatment of schizophrenia in adolescents and adults within the United Kingdom.


Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
25 Aug 2022
Historique:
received: 04 01 2022
accepted: 04 08 2022
entrez: 24 8 2022
pubmed: 25 8 2022
medline: 27 8 2022
Statut: epublish

Résumé

Schizophrenia is a serious mental health condition characterised by distortions in thought processes, perception, mood, sense of self, and behaviour. Lurasidone, a second-generation atypical antipsychotic, represents an additional treatment option alongside existing antipsychotics for adolescents and adults with schizophrenia. An economic model was developed to evaluate the incremental costs of lurasidone as a first-line treatment option compared to existing antipsychotics. A Markov model was developed to estimate the cost impact of lurasidone as a first-line treatment option for both adolescents and adults. The sequence-based model incorporated the following health states: stable (no relapse or discontinuation), discontinuation (due to adverse events or other reasons), and relapse. Data used to determine the movement of patients between health states were obtained from network meta-analyses (NMAs). The time horizon ranged from three to five years (depending on the patient population) and a six-weekly cycle length was used. Unit costs and resource use were reflective of the UK NHS and Personal Social Services and consisted of the following categories: outpatient, adverse events, primary and residential care. Extensive deterministic sensitivity analysis was undertaken to assess the level of uncertainty associated with the base case results. Lurasidone is demonstrated to be cost-saving as a first-line treatment within the adolescent and adult populations when compared to second-line and third-line respectively. Lurasidone is more expensive in terms of treatment costs, resource use (in the stable health state) and the treatment of adverse events. However, these costs are outweighed by the savings associated with the relapse health state. Lurasidone remains cost-saving when inputs are varied in sensitivity analysis and scenario analysis. Lurasidone is a cost-saving first-line treatment for schizophrenia for both adolescents and adults.

Sections du résumé

BACKGROUND BACKGROUND
Schizophrenia is a serious mental health condition characterised by distortions in thought processes, perception, mood, sense of self, and behaviour. Lurasidone, a second-generation atypical antipsychotic, represents an additional treatment option alongside existing antipsychotics for adolescents and adults with schizophrenia. An economic model was developed to evaluate the incremental costs of lurasidone as a first-line treatment option compared to existing antipsychotics.
METHODS METHODS
A Markov model was developed to estimate the cost impact of lurasidone as a first-line treatment option for both adolescents and adults. The sequence-based model incorporated the following health states: stable (no relapse or discontinuation), discontinuation (due to adverse events or other reasons), and relapse. Data used to determine the movement of patients between health states were obtained from network meta-analyses (NMAs). The time horizon ranged from three to five years (depending on the patient population) and a six-weekly cycle length was used. Unit costs and resource use were reflective of the UK NHS and Personal Social Services and consisted of the following categories: outpatient, adverse events, primary and residential care. Extensive deterministic sensitivity analysis was undertaken to assess the level of uncertainty associated with the base case results.
RESULTS RESULTS
Lurasidone is demonstrated to be cost-saving as a first-line treatment within the adolescent and adult populations when compared to second-line and third-line respectively. Lurasidone is more expensive in terms of treatment costs, resource use (in the stable health state) and the treatment of adverse events. However, these costs are outweighed by the savings associated with the relapse health state. Lurasidone remains cost-saving when inputs are varied in sensitivity analysis and scenario analysis.
CONCLUSIONS CONCLUSIONS
Lurasidone is a cost-saving first-line treatment for schizophrenia for both adolescents and adults.

Identifiants

pubmed: 36002828
doi: 10.1186/s12913-022-08436-x
pii: 10.1186/s12913-022-08436-x
pmc: PMC9404623
doi:

Substances chimiques

Antipsychotic Agents 0
Lurasidone Hydrochloride O0P4I5851I

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1084

Informations de copyright

© 2022. The Author(s).

Références

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pubmed: 33505160
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pubmed: 29950586
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pubmed: 31829775
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pubmed: 22584864
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pubmed: 18180760
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pubmed: 22124274
Cochrane Database Syst Rev. 2013 Nov 15;(11):CD003082
pubmed: 24242360
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pubmed: 27067724
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pubmed: 31303314
Sci Rep. 2021 Mar 10;11(1):5571
pubmed: 33692392
BJPsych Open. 2016 Feb 5;2(1):59-66
pubmed: 27703755
Epidemiol Rev. 2008;30:67-76
pubmed: 18480098

Auteurs

Amy Dymond (A)

York Health Economics Consortium (YHEC), York, UK. amy.dymond@york.ac.uk.

Daniela Afonso (D)

York Health Economics Consortium (YHEC), York, UK.

Will Green (W)

York Health Economics Consortium (YHEC), York, UK.

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Classifications MeSH