Schizophrénie : évaluation du coût de la prise en charge

Raymond, Sophie; Martín, Myriam; Netillard, Christian; Mejat-Alder, E.; Woronoff‐Lemsi, M.‐C.; Tissot, Edgar

doi:10.3917/jgem.097.0421

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…In the extra scenario associated with using the cost of hospitalisation from Raymond et al [ 24 ] (i.e. €277.70 in December 2014), paliperidone LAI remained the least costly LAI.…”

Section: Resultsmentioning

confidence: 99%

“…CPI 2014/CPI 2012] = €436.84 in December 2014) [ 57 ]. A lower cost was identified by Raymond et al [ 24 ], with a daily hospitalisation cost at €288.30 in 2009 (i.e. €288.30 × 99.6/103.4 [i.e.…”

Section: Methodsmentioning

confidence: 99%

“…€288.30 × 99.6/103.4 [i.e. CPI 2014/CPI 2009] = €277.70 in December 2014) and was assessed in an extra scenario [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Few economic studies have been conducted in France assessing either the costs associated with schizophrenia or the benefit/costs ratio of antipsychotics [ 24 , 25 ]. In 2005, a French study comparing three antipsychotics established superiority with LAI risperidone compared with LAI haloperidol and oral olanzapine [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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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

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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...

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“…In the extra scenario associated with using the cost of hospitalisation from Raymond et al [ 24 ] (i.e. €277.70 in December 2014), paliperidone LAI remained the least costly LAI.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…€288.30 × 99.6/103.4 [i.e. CPI 2014/CPI 2009] = €277.70 in December 2014) and was assessed in an extra scenario [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

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“…Le statut de réserve hospitalière induit également un biais de mode de prise en charge puisqu'il fait forcément appel à la mobilisation de ressources hospitalières. Nous avons fait le choix de ne pas inclure les coûts ambulatoires car nous nous sommes heurtés à des problèmes de faisabilité (non-accès aux données de la caisse d'Assurance Maladie) et parce qu'ils semblent être bien inférieurs aux coûts directs hospitaliers [28]. Cependant, il manque l'intégration des coûts indirects (prestations sociales, indemnités d'arrêt de travail, etc.)…”

Section: Discussionunclassified

Étude coût-efficacité du pamoate d’olanzapine : analyse en miroir sur un an

et al. 2019

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Costs of Schizophrenia at Psychiatric Hospital of Bingerville (Ivory Coast)

Anoumatacky,

Bissouma,

Kone

2024

OJPsych

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Schizophrenia is classified as a priority mental disorder by the World Health Organization (WHO) and accounts for around 35% of diagnoses at the Bingerville Psychiatric Hospital (HPB). The aims of the study were to identify the cost drivers for hospitalization and to calculate the costs of managing schizophrenia in hospital, with a view to planning household expenditure on care. This pilot cross-sectional study involved 31 patients with schizophrenia who had been hospitalized in the various third-category wards at the HPB between 1st January 2019 and 31st May 2020. Sampling was accidental. The methods used to estimate costs were based on the actual costs of drugs, hospitalization and additional examinations which prices were known, and on patients' estimations for certain expenses such as food and transport. Results: The sex ratio was 3.42, the mean age was 29.52 years. The mean length of stay was 46.19 days, and the most frequent clinical forms were paranoid schizophrenia (41.9%) and schizoaffective disorder (29%). The combination of haloperidol and chlorpromazine was the most common medications for initial treatment (67.8%) and maintenance treatment (41.9%). The average cost of hospitalization at HPB for schizophrenia was XOF 164,412 (€249.90). The average direct medical cost was XOF 105,412 (€160.226) and the average direct non-medical cost was XOF 59,000 (€89.68). The average daily cost of antipsychotic treatment was XOF 795/day (€1.2084). The high cost of drugs as a proportion of hospitalization costs suggested the need of a reflection on the simplification of prescribing practices, assistance in psychiatric emergencies and the development of other alternatives to psychiatric hospitalization in Côte d'Ivoire.

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Schizophrénie : évaluation du coût de la prise en charge

Cited by 3 publications

References 4 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

Étude coût-efficacité du pamoate d’olanzapine : analyse en miroir sur un an

Costs of Schizophrenia at Psychiatric Hospital of Bingerville (Ivory Coast)

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