Cost-Utility Analysis of Depot Atypical Antipsychotics for Chronic Schizophrenia in Croatia

Jukić, Vlado; Jakovljević, Mihajlo; Filipčić, Igor; Herceg, Miroslav; Silić, Ante; Tomljanović, Tatjana; Zilbershtein, Roman; Jensen, R.; Hemels, M.; Einarson, Thomas R.

doi:10.1016/j.vhri.2013.06.008

Cited by 8 publications

(2 citation statements)

References 41 publications

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“…This model was a decision tree comparing the 1-year economic consequence of 3-line antipsychotic treatment sequences. It was selected according to the following reasons: 1) its structure was widely used with eight adaptations [17][18][19][20][21][22][23][24]; 2) it did not consider utility values for the health states other than schizophrenia, such as treatmentrelated side effects; 3) it was a simple model requiring fewer interpretations to replicate the model. Our analysis only compared olanzapine long-acting injection (LAI) with risperidone LAI as a first-line treatment, since this comparison generated non-dominance ICER results in Einarson et al [17].…”

Section: Methodsmentioning

confidence: 99%

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

Zhou

Millier

François

et al. 2019

Journal of Market Access & Health Policy

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Background and Objectives: Utility elicitation studies for schizophrenia generate different utility values for the same health states. We reviewed utility values used in schizophrenia pharmacoeconomic evaluations and evaluated the impact of their selection on the incremental costeffectiveness ratio (ICER). Methods: A systematic search was performed in Medline and Embase. Health state definitions, associated utility values, elicitation studies, and value selection processes were extracted. Sets of utility values for all schizophrenia health states were used in a cost-effectiveness model to evaluate the ICER. Results: Thirty-five cost-utility analyses (CUAs) referring to 11 utility elicitation studies were included. The most frequent health states were 'stable' (28 CUAs, 7 utility elicitation studies, 10 values, value range 0.650-0.919), 'relapse requiring hospitalisation' (18, 5, 7, 0.270-0.604), 'relapse not requiring hospitalisation' (18, 5, 10, 0.460-0.762), and 'relapse only' (10, 5, 6, 0.498-0.700). Seventeen sets of utility values were identified with difference in utility values between relapse and stable ranging from −0.358 to −0.050, resulting in ICERs ranging from −56.2% to +222.6% from average. Conclusion: The use of utility values for schizophrenia health states differs among CUAs and impacts on the ICER. More rigorous and transparent use of utility values and sensitivity analysis with different sets of utility values are suggested for future CUAs.

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Section: Methodsmentioning

confidence: 99%

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

Zhou

Millier

François

et al. 2019

Journal of Market Access & Health Policy

View full text Add to dashboard Cite

show abstract

“…Some patient characteristics were only mentioned by a single study; for example, one study discussed how stigma may be tied to adherence. 28 Adherence (likely determined by patient characteristics and a range of other factors, eg, intervention design) was considered as both a baseline patient characteristic and a parameter affected by baseline patient characteristics. Another study varied treatment location (eg, hospital) by whether a patient could take care of themselves (based on PANSS score and a random score for social and environmental factors representing a patients' informal care network) but did not justify this.…”

Section: Patient Heterogeneitymentioning

confidence: 99%

Acknowledging Patient Heterogeneity in Economic Evaluations in Schizophrenia: A Systematic Review

et al. 2022

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A Systematic Review of Economic Models Across the Entire Schizophrenia Pathway

et al. 2020

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Background: Schizophrenia is associated with a high economic burden. Economic models can help to inform resource allocation decisions to maximise benefits to patients.Objectives: This systematic review aims to assess the availability, quality and consistency of conclusions of health economic models evaluating the cost-effectiveness of interventions for schizophrenia. Methods: An electronic search was performed on multiple databases (MEDLINE, EMBASE, PsycInfo, Cochrane database of systematic reviews, NHS Economic Evaluation Database and Health Technology Assessment database) to identify economic models of interventions for schizophrenia published between 2005-2020. Two independent reviewers selected studies for inclusion. Study quality was assessed using the National Institute for Health and Care Excellence (NICE) checklist and the Cooper hierarchy. Model characteristics and conclusions were descriptively summarised. Results: Seventy-three models met inclusion criteria. 78% of existing models assessed antipsychotics, however, due to inconsistent conclusions reported by different studies, no antipsychotic can be considered clearly costeffective compared with the others. A very limited number of models suggest that the following nonpharmacological interventions might be cost-effective: psychosocial interventions, stratified tests, employment intervention and intensive intervention to improve liaison between primary and secondary care. The quality of included models is generally low due to use of a short time horizon, omission of adverse events of interventions, poor data quality and potential conflicts of interest.Conclusions: This review highlights a lack of models for non-pharmacological interventions, and limitations of the existing models, including low quality and inconsistency in conclusions. Recommendations on future modelling approaches for schizophrenia are provided. Key Points for Decision Makers• This is the first systematic review of model-based economic analyses which covers the entire schizophrenia care pathway, by including any intervention for the prevention, detection, diagnosis, treatment and follow-up of schizophrenia.• This review highlights a lack of models for non-pharmacological interventions, and low quality of existing models. Common reasons for low-quality include use of a time-horizon which is not sufficiently long, failure to capture the health and cost impact of adverse events of the interventions under assessment, and potential conflicts of interest.• Due to inconsistent conclusions reported by different studies, no antipsychotic can be considered clearly cost-effective compared with the others. A very limited number of models suggest that the following non-pharmacological interventions might be cost-effective: psychosocial interventions, stratified tests, employment intervention and intensive intervention to improve liaison between primary and secondary care.• A consistent basis for the model structure, use of evidence and assumptions in health economic models is required in order to i...

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Cost-Utility Analysis of Depot Atypical Antipsychotics for Chronic Schizophrenia in Croatia

Cited by 8 publications

References 41 publications

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

Systematic review of utility values used in the pharmacoeconomic evaluations for schizophrenia: implications on cost-effectiveness results

Acknowledging Patient Heterogeneity in Economic Evaluations in Schizophrenia: A Systematic Review

A Systematic Review of Economic Models Across the Entire Schizophrenia Pathway

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