Cost-effectiveness of aripiprazole once-monthly compared with paliperidone palmitate once-monthly injectable for the treatment of schizophrenia in the United States

Citrome, Leslie; Kamat, Siddhesh; Sapin, Christophe; Baker, Ross A.; Eramo, Anna; Ortendahl, Jesse; Gutiérrez, Benjamín; Hansen, Karina; Bentley, Tanya G. K.

doi:10.3111/13696998.2014.917089

Cited by 24 publications

(49 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six analyses assessing the cost effectiveness of paliperidone LAI have been identified in other countries: Mehnert et al [ 28 ] in Sweden, Zeidler et al [ 29 ] in Germany, Kolek et al [ 64 ] in the Czech Republic, Einarson et al [ 63 ] in Finland, Citrome et al [ 65 ] in the USA and Lee et al in Wales [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent cost-effectiveness analysis was conducted in the USA to assess the efficiency of aripiprazole LAI versus paliperidone LAI in various dosing scenarios [ 65 ]. Overall, results were in favour of aripiprazole LAI, as it was associated with fewer relapses at lower costs or a reasonable cost-effectiveness threshold compared with paliperidone LAI at the 1-year time horizon.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France

Druais¹,

Doutriaux

Cognet

et al. 2016

PharmacoEconomics

View full text Add to dashboard Cite

BackgroundFrench clinical recommendations suggest prescribing long-acting injectable (LAI) antipsychotics to patients with a maintenance treatment indication in schizophrenia. Despite this, and due to their relatively high acquisition and administration costs, LAIs are still underused in clinical practice in France, thus highlighting the need for pharmacoeconomic evaluations.ObjectiveOur objective was to estimate the cost effectiveness of paliperidone LAI (or paliperidone palmitate), a once-monthly second-generation LAI antipsychotic, compared with the most common antipsychotic medications for the maintenance treatment of schizophrenia in France.MethodsA Markov model was developed to simulate the progression of a cohort of schizophrenic patients through four health states (stable treated, stable non-treated, relapse and death) and to consider up to three lines of treatment to account for changes in treatment management. Paliperidone LAI was compared with risperidone LAI, aripiprazole LAI, olanzapine LAI, haloperidol LAI (or haloperidol decanoate) and oral olanzapine. Costs, quality-adjusted life-years (QALYs) and number of relapses were assessed over 5 years based on 3-month cycles with a discount rate of 4 % and from a French health insurance perspective. Patients were considered to be stabilised after a schizophrenic episode and would enter the model at an initiation phase, followed by a prevention of relapse phase if successful. Data (e.g. relapse or discontinuation rates) for the initiation phase came from randomised clinical trials, whereas relapse rates in the prevention phase were derived from hospitalisation risks based on real-life French data to capture adherence effects. Safety and utility data were derived from international publications. Additionally, costs were retrieved from French health insurance databases and publications. Finally, expert opinion was used for validation purposes or in case of gaps in data. The robustness of results was assessed through deterministic and probabilistic sensitivity analyses.ResultsAll LAI antipsychotics were found to have similar costs over 5 years: approximatively €55,000, except for paliperidone LAI which had a discounted cost of €50,880. Oral olanzapine was less costly than LAIs (i.e. €50,379 after 5 years) but was associated with fewer QALYs gained and relapses avoided. Paliperidone LAI dominated aripiprazole LAI, olanzapine LAI and haloperidol LAI in terms of costs per QALY, and it was associated with slightly fewer QALYs when compared with risperidone LAI (i.e. 3.763 vs 3.764). This resulted in a high incremental cost-effectiveness ratio (ICER) (i.e. €4,770,018 per QALY gained) for risperidone LAI compared with paliperidone LAI. Paliperidone LAI was more costly than olanzapine oral but associated with more QALYs (i.e. ICER of €2411 per QALY gained for paliperidone LAI compared with oral olanzapine). Paliperidone LAI had a probability of being the optimal strategy in more than 50 % of cases for a willingness-to-pay threshold of €8000 per QALY gained.Conclusion...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France

Druais¹,

Doutriaux

Cognet

et al. 2016

PharmacoEconomics

View full text Add to dashboard Cite

show abstract

“…Although data are limited, a recent systematic review of the cost-effectiveness of LAI antipsychotics in the management of schizophrenia did conclude that the use of atypical LAI antipsychotics is likely to be a cost-effective strategy [53]. Likewise, a cost-effectiveness analysis from a US payer perspective concluded that aripiprazole LAI maintenance therapy is likely to be a cost-effective treatment option in patients with schizophrenia [54].…”

Section: Current Status Of Aripiprazole (Abilify Maintena ò ) In the mentioning

confidence: 98%

Aripiprazole (ABILIFY MAINTENA®): A Review of Its Use as Maintenance Treatment for Adult Patients with Schizophrenia

Shirley¹,

Perry²

2014

Drugs

View full text Add to dashboard Cite

Aripiprazole (ABILIFY(®)) is an atypical antipsychotic drug that is proposed to act via partial agonism of dopamine D2 receptors. Trials with oral aripiprazole have shown that, compared with some other atypical antipsychotics, aripiprazole is associated with fewer metabolic disturbances and has a favourable cardiovascular tolerability profile. Recently, an intramuscular long-acting injectable (LAI) depot formulation of aripiprazole (ABILIFY MAINTENA(®)) (aripiprazole LAI) has been approved for use as a treatment for schizophrenia in adults. The efficacy of aripiprazole LAI as a maintenance treatment for schizophrenia has been demonstrated in randomized clinical trials. In the trials, aripiprazole LAI was more effective than placebo, and noninferior to oral aripiprazole, in delaying relapse and in reducing relapse rates in schizophrenia. Aripiprazole LAI was generally well tolerated, with a tolerability profile consistent with that of oral aripiprazole. Thus, aripiprazole LAI is a valuable new treatment option for adult patients with schizophrenia. It may be of particular use for patients stable on oral aripiprazole who would prefer, or are likely to benefit from, a long-acting formulation.

show abstract

“…32,33 In addition, a head-to-head comparison with paliperidone palmitate showed superiority for aripiprazole monohydrate on a quality-of-life scale, 34 and pharmacoeconomic models further establish aripiprazole monohydrate as a dominant choice vs paliperidone palmitate when higher doses of the latter are utilized. 35…”

Section: -Month Paliperidone Palmitatementioning

confidence: 99%

Emerging pharmacological therapies in schizophrenia: what’s new, what’s different, what’s next?

Citrome

2016

CNS Spectr.

Self Cite

View full text Add to dashboard Cite

There are several new and emerging medication interventions for both the acute and maintenance treatment phases of schizophrenia. Recently approved are 2 new dopamine receptor partial agonists, brexpiprazole and cariprazine, as well as 2 new long-acting injectable antipsychotic formulations, aripiprazole lauroxil and 3-month paliperidone palmitate. Although differences in efficacy compared to other available choices are not expected, the new oral options offer different tolerability profiles that may be attractive for individual patients who have had difficulties with older medications. The new long-acting injectable options provide additional flexibility in terms of increasing the time interval between injections. In Phase III of clinical development is a novel antipsychotic, lumateperone (ITI-007), that appears to have little in the way of significant adverse effects. Deutetrabenazine and valbenazine are agents in Phase III for the treatment of tardive dyskinesia, a condition that can be found among persons receiving chronic antipsychotic therapy. On the horizon are additional injectable formulations of familiar antipsychotics, aripiprazole and risperidone, that may be more convenient than what is presently available.

show abstract

Cost-effectiveness of aripiprazole once-monthly compared with paliperidone palmitate once-monthly injectable for the treatment of schizophrenia in the United States

Cited by 24 publications

References 29 publications

Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France

Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France

Aripiprazole (ABILIFY MAINTENA®): A Review of Its Use as Maintenance Treatment for Adult Patients with Schizophrenia

Emerging pharmacological therapies in schizophrenia: what’s new, what’s different, what’s next?

Contact Info

Product

Resources

About