Annual cost of relapses and relapse-related hospitalizations in adults with
schizophrenia: results from a 12-month, double-blind, comparative study of
lurasidone vs quetiapine extended-release.
Author(s): Rajagopalan K(1), O'Day K, Meyer K, Pikalov A, Loebel A.
Affiliation(s): Author information:
(1)Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.
Publication date & source: 2013, J Med Econ. , 16(8):987-96
PURPOSE: To model the economic impact of annual relapses/relapse-related
hospitalizations among adults with schizophrenia treated with lurasidone or
quetiapine extended-release (XR).
METHODS: A probabilistic model estimating per-patient-per-year (PPPY) direct
mental healthcare (MH) cost differences due to relapses/relapse-related
hospitalizations was developed using relapse and relapse-related hospitalization
rates from a 12-month, double-blind, parallel-group, global comparison study of
lurasidone vs quetiapine XR (all patients previously treated with lurasidone or
quetiapine XR for 6 weeks). Analyses were conducted for both all subjects and
clinical responders. Direct costs associated with inpatient and outpatient mental
healthcare-related services were obtained from a large, prospective,
observational study of schizophrenia treatment in usual-care settings for
relapsing and non-relapsing patients, including psychiatric hospitalizations,
emergency services, medication management, and outpatient individual therapy.
Model robustness was tested using univariate and probabilistic sensitivity
analyses.
RESULTS: Model-estimated PPPY MH cost savings associated with relapse-related
hospitalization rates in all subjects were $3276 for lurasidone vs quetiapine XR.
Lurasidone resulted in PPPY MH cost savings of $2702 vs quetiapine XR in all
subjects, using relapse rates. Sensitivity analyses indicated lurasidone had
lower 1-year MH costs than quetiapine XR in 100% and 99.7% of simulations, using
relapse-related hospitalization rates and relapse rates, respectively, in all
subjects. Similar results were seen in clinical responders.
LIMITATIONS: The model represents a simplification of treatment patterns and
response to treatment. Cost of treatment with lurasidone and quetiapine XR was
not included in the model. Estimates of cost savings are likely conservative, as
the model did not assess the impact of long-term cardiometabolic consequences.
Indirect costs associated with relapses and non-mental health-related costs were
also excluded from the model.
CONCLUSION: Adults treated for schizophrenia with lurasidone are predicted to
have lower 12-month MH costs compared to those treated with quetiapine XR due to
fewer relapses and relapse-related hospitalizations.
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