One-year clinical and economic consequences of oral atypical antipsychotics in the treatment of schizophrenia

Edwards, Natalie C; Pesa, Jacqueline; Meletiche, DM; Engelhart, Luella; Thompson, Ann; Sherr, Jay D.; Dirani, Riad

doi:10.1185/03007990802490512

Cited by 26 publications

(29 citation statements)

References 29 publications

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“…The 24 studies included represent data from 14 countries: eight articles from the USA Tunis et al, 2006;Bounthavong & Okamoto, 2007;Edwards et al, 2008;Furiak et al, 2009;Ascher-Svanum et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013), two from Canada (Cooper et al, 2008;Mcintyre et al, 2010) and Spain (Garcia-Ruiz et al, 2012;Treur et al, 2012) and one from Slovenia (Obradovic et al, 2007), Italy (Colombo et al, 2008), Greece (Geitona et al, 2008), Belgium (De Ridder & De Graeve, 2009), Brazil (Lindner et al, 2009), Mexico (Mould-Quevedo et al, 2009, China (Yang et al, 2009), Norway (Kim & Aas, 2011), Sweden (Lindström et al, 2011), Germany (Zeidler et al, 2013) and Vietnam (Anh et al, 2015). One study evaluated the cost-effectiveness of antipsychotics in European countries .…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…A utility component was found in 13 included studies, 12 of them reported effectiveness in measures of QALYs Knapp et al, 2008;De Ridder & De Graeve, 2009;Furiak et al, 2009;Lindner et al, 2009;Mcintyre et al, 2010;Ascher-Svanum et al, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;Garcia-Ruiz et al, 2012;Treur et al, 2012;Zeidler et al, 2013) and one of them in DALYs averted (Anh et al, 2015). Regarding the source of data and modeling, three studies were based on Randomized Clinical Trials (RCTs) Tunis et al, 2006;Ascher-Svanum et al, 2011), three studies analyzed data from observational studies (Cooper et al, 2008;Knapp et al, 2008;De Ridder & De Graeve, 2009), nine studies built Markov models with literature data (Lindner et al, 2009;Mould-Quevedo et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013;Zeidler et al, 2013;Anh et al, 2015) and nine studies only reported a decision analysis model with literature data (Bounthavong & Okamoto, 2007;Obradovic et al, 2007;Colombo et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Furiak et al, 2009;Yang et al, 2009;Garcia-Ruiz et al, 2012;Treur et al, 2012). Most studies adopted time horizons of one year (Tunis et al, ...…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Regarding the source of data and modeling, three studies were based on Randomized Clinical Trials (RCTs) Tunis et al, 2006;Ascher-Svanum et al, 2011), three studies analyzed data from observational studies (Cooper et al, 2008;Knapp et al, 2008;De Ridder & De Graeve, 2009), nine studies built Markov models with literature data (Lindner et al, 2009;Mould-Quevedo et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;Lindström et al, 2011;Ascher-Svanum et al, 2012;O'day et al, 2013;Zeidler et al, 2013;Anh et al, 2015) and nine studies only reported a decision analysis model with literature data (Bounthavong & Okamoto, 2007;Obradovic et al, 2007;Colombo et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Furiak et al, 2009;Yang et al, 2009;Garcia-Ruiz et al, 2012;Treur et al, 2012). Most studies adopted time horizons of one year (Tunis et al, 2006;Obradovic et al, 2007;Cooper et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Knapp et al, 2008;Furiak et al, 2009;Mould-Quevedo et al, 2009;Ascher-Svanum et al, 2011;Garcia-Ruiz et al, 2012) and five years (Colombo et al, 2008;Lindner et al, 2009;Mcintyre et al, 2010;Kim & Aas, 2011;…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Chlorpromazine was not evaluated in any of the included studies. Regarding the funding, six studies were not funded by any pharmaceutical company Bounthavong & Okamoto, 2007;Obradovic et al, 2007;Lindner et al, 2009;Kim & Aas, 2011;Anh et al, 2015), six studies were funded by Eli Lilly companies (Tunis et al, 2006;Knapp et al, 2008;De Ridder & De Graeve, 2009;Furiak et al, 2009;Ascher-Svanum et al, 2011;Ascher-Svanum et al, 2012), seven studies by Janssen-Cilag companies (Cooper et al, 2008;Edwards et al, 2008;Geitona et al, 2008;Yang et al, 2009;Garcia-Ruiz et al, 2012;Treur et al, 2012;Zeidler et al, 2013), one study by Bristol-Myers Squibb (Colombo et al, 2008), one study by Sunovion (O'day et al, 2013), one study by H. Lundbeck (Lindström et al, 2011) and two studies by Pfizer companies (Mould-Quevedo et al, 2009;Mcintyre et al, 2010) (Table 1). …”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Santos¹,

Godói²,

Vidal³

et al. 2017

JBES

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Objective: The aim of this study is to conduct a systematic review on cost-effectiveness analysis of oral antipsychotic agents to identify the trend of cost-effectiveness of drugs available for the treatment of schizophrenia. Methods: A search was conducted in three databases (MEDLINE, LILACS and PsycINFO) for head-to-head economic comparisons of antipsychotic agents. A manual search in journals, dissertations and theses databases, congresses abstracts and the Cochrane Library was also conducted to ensure comprehensiveness. After evaluation by independent reviewers, complete economic evaluations of oral antipsychotic medications were included in the final analysis. Results: Twenty four studies were included in the final analysis. The trend observed in the pooled studies showed that risperidone, olanzapine and clozapine were the most cost-effective drugs included to treat schizophrenia. Aripiprazole and haloperidol were considered comparable to quetiapine or ziprasidone and less cost-effective than olanzapine and risperidone in the pooled analysis. After removal of comparisons that had sponsored drugs included, risperidone, olanzapine and clozapine were still considered the most cost-effective strategies to treat schizophrenia. The analysis of only cost-utility studies shows approximately the same results of the other analysis. Conclusions: An analysis that consider first-vs. second-generation antipsychotics polled together might be biased by the different profiles of the specific drugs, not considering the heterogeneity of the group of second-generation antipsychotics. There seems to be a difference in the cost-effectiveness profiles between specific antipsychotic drugs. Risperidone, olanzapine and clozapine seem to be the drugs most considered cost-effective to treat schizophrenia. This result was robust to changes in funding. RESUMOObjetivo: O objetivo deste estudo é conduzir uma revisão sistemática de custo-efetividade de antipsicóticos orais para identificar uma tendência de custo-efetividade dos medicamentos disponí-veis para o tratamento da esquizofrenia. Métodos: Uma busca eletrônica foi realizada nas bases de dados Medline (via PubMed), Lilacs (via VS) e PsycINFO para avaliações econômicas comparando head-to-head medicamentos antipsicóticos para esquizofrenia. Uma busca manual complementar foi realizada para garantir abrangência. Resultados: Depois da avaliação por revisores independen- tes, 24 avaliações econômicas completas de antipsicóticos orais para esquizofrenia foram incluí-das na análise final. A tendência observada no conjunto dos estudos mostrou que a risperidona, a olanzapina e a clozapina foram mais comumente consideradas os medicamentos mais custo--efetivos para esquizofrenia. Aripiprazol e olanzapina foram considerados comparáveis a quetiapina ou ziprasidona e menos custo-efetivos, no geral, que olanzapina e risperidona. Após a remoção das comparações que incluíam medicamentos dos patrocinadores dos estudos, a mesma tendência foi observada. A análise apenas de estudos de custo-utili...

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Santos¹,

Godói²,

Vidal³

et al. 2017

JBES

View full text Add to dashboard Cite

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“…È stata condotta un'analisi di costo-efficacia nella prospettiva del SSN italiano mediante l'adattamento di un modello originariamente sviluppato negli Stati Uniti per la stima del costo medio per giorno stabile (stable days, intesi come periodo della malattia senza ricadute), valutando 5 antipsicotici atipici: paliperidone ER, risperidone, olanzapina, quetiapina e aripiprazolo [34]. L'adattamento si è riferito sostanzialmente all'applicazione dei consumi e dei costi relativi al Sistema Sanitario Nazionale italiano.…”

Section: Metodiunclassified

Decision analytic economic paliperidone ER in relapsing schizophrenic patients in Italy

Berto

Negrini

Ferrannini³

2008

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Schizophrenia, with its typical chronic and relapsing course, is very burdensome, both clinically and economically. Its pharmacological management relies on two main drug classes: the older, or typical, antipsychotics, which are quite effective on positive symptoms, but limited by low tolerability and poor efficacy on negative symptoms, and atypical antipsychotics, which are better tolerated and effective on a wider range of psychotic symptoms. In this article, the authors briefly discuss current management options for patients with schizophrenia and highlight some unmet clinical needs in the field. After outlining the main clinical features shown by paliperidone ER, a novel antipsychotic, in its clinical development program, a decision analytic economic appraisal of its use in relapsing schizophrenic patients in Italy, as compared to the other available atypical antipsychotics, is presented. Under base-case assumption and after applying national costs and tariffs, the model predicts paliperidone ER to be associated with better clinical outcomes, expressed in terms of stable days, and lower costs; this means that paliperidone is dominant over the alternatives, according to the principles of economic evaluation of healthcare technologies. One-way sensitivity analyses conducted on structural and cost parameters indicated robustness of base-case estimates, which remain to be confirmed by "real world" national data. Attualmente il trattamento farmacologico della schizofrenia si basa su due principali classi di farmaci: Keywordsantipsicotici di 1 a generazione (detti anche antipsicotici "tipici o convenzionali"), molto efficaci sui sintomi positivi (deliri, allucinazioni, pensiero disorganizzato, comportamento disorganizzato), ma inefficaci su altre dimensioni della schizofrenia e caratterizzati da una scarsa tollerabilità (es. elevata incidenza di effetti extrapiramidali) [2,3]; antipsicotici di 2 a generazione (detti "atipici"), con efficacia paragonabile ai precedenti sui sintomi positivi, ma caratterizzati da un'efficacia su un più ampio spettro di sintomi quali quelli negativi (ridotta emotività, appiattimento affettivo, apatia, anedonia, alogia), quelli affettivi e cognitivi e da un migliore profilo di tollerabilità neurologica rispetto ai tradizionali (minore propensione ad indurre effetti extrapiramidali) [2, 3]. -- INTRODUZIONELa schizofrenia rappresenta un disturbo psichiatrico severo e invalidante. È una patologia con tendenza alla cronicizzazione, che insorge prevalentemente in età giovanile e che si ritiene causata da più fattori concomitanti (genetici, ambientali biologici, psicosociali).Le manifestazioni cliniche più frequenti sono sintomi psicotici (deliri, allucinazioni, pensiero e/o comportamento disorganizzato), apatia, isolamento sociale e disturbi cognitivi.La schizofrenia colpisce circa l'1% della popolazione (prevalenza lifetime) e mostra un'incidenza annuale di 0,2-0,4/1.000. È una patologia estremamente gravosa sia per il paziente che per i suoi familiari: comporta conseguenze di dis...

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Oral paliperidone for schizophrenia

Nussbaum

Stroup

2008

Cochrane Database of Systematic Reviews

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In short-term studies, oral paliperidone is an antipsychotic that is more efficacious than placebo. We found its adverse effects to be similar to those of its parent compound, risperidone, with movement disorders, weight gain, and tachycardia all more common with paliperidone than placebo. In addition, paliperidone is associated with substantial increases in serum prolactin that may be associated with sexual dysfunction, although sexual functioning outcomes were not reported. At doses greater than 3 mg per day, oral paliperidone appears comparable in efficacy to oral olanzapine 10 mg per day. Regarding the critical comparison of oral paliperidone to risperidone, we have no information and are thus unable to determine if paliperidone has any advantages or disadvantages compared to its well-known parent compound.

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One-year clinical and economic consequences of oral atypical antipsychotics in the treatment of schizophrenia

Cited by 26 publications

References 29 publications

Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Economic evaluation of antipsychotics for the treatment of schizophrenia: a systematic review

Decision analytic economic paliperidone ER in relapsing schizophrenic patients in Italy

Oral paliperidone for schizophrenia

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