- Email: [email protected]
24 – Direct healthcare costs after initiation of oral antipsychotic treatment for schizophrenia: Efficacy versus tolerability
ABSTRACTS / Schizophrenia Research 98 (2008) 3–199
43
[1] Davis, J.M., 2006. The choice of drugs for schizophrenia. N Engl J Med. 354, 518–520.
25 – DEVELOPMENT OF A COST-EFFECTIVENESS MODEL FOR EVALUATING TREATMENT OF ACUTE MANIA/MIXED MANIA IN BIPOLAR I DISORDER
doi:10.1016/j.schres.2007.12.090
A. Fagiolini 1, J. Mauskopf 2, M.R. Wilson 2, J. Harnett 3, K.N. Sanders 3, C. Kremer 3.
Reference:
1
University of Pittsburgh, Pittsburgh, PA, USA RTI Health Solutions, Research Triangle Park, NC, USA 3 Pfizer Inc., New York, NY, USA 2
24 – DIRECT HEALTHCARE COSTS AFTER INITIATION OF ORAL ANTIPSYCHOTIC TREATMENT FOR SCHIZOPHRENIA: EFFICACY VERSUS TOLERABILITY J. Diels 1, K. Trakas 2, D. Nicholl 3, G. Nuyts 3. 1 Health Economics, Johnson and Johnson Pharmaceutical Services, Beerse, Belgium 2 Health Economics, Janssen-Ortho, Toronto, Canada 3 Health Economics, Johnson Pharmaceutical Services, Raritan, USA
Presenting Author details: [email protected] Turnhoutseweg 30, B-2340 Beerse, Belgium, Tel.: +32 14 603443; fax: +32 14 605425. Background: Variations in efficacy and tolerability profiles between atypical antipsychotics were hypothesized to lead to differences in direct healthcare costs in the management of schizophrenia. This analysis tested the difference between two groups of agents: those rated as more highly effective [1], olanzapine and risperidone, versus those with potential higher tolerability, aripiprazole, quetiapine and ziprasidone. Methods: Pharmetrics, a large US outpatient insurance claims database with regionally representative coverage, was analyzed for patients diagnosed with schizophrenia (ICD-9-CM code) initiating a new antipsychotic treatment (Jan 02 and Mar 05). Total medical costs, including all inpatient and outpatient costs related to the treatment of schizophrenia were examined in the year following the initiation of the treatment. Costs were assessed for each drug individually and for: (i) risperidone or olanzapine and (ii) aripiprazole, quetiapine or ziprasidone and examined using generalized gamma regression (GLM). All analyses were carried out on an intent-to-treat population and adjusted for potential confounders. Results: 2261 patients initiated on risperidone (54%) or olanzapine (46%) and 2571 patients initiated on aripiprazole (35%), quetiapine (40%) or ziprasidone (25%) met inclusion criteria. After adjustment for differences, the cost of overall health care was significantly higher in the patient group initiated with aripiprazole, quetiapine or ziprasidone compared to patients initiated on risperidone or olanzapine (GLM coefficient 1.13, 19.641 vs. 17.402, p b 0.0001). Higher inpatient costs were the main cost driver for differences between groups (GLM coefficient 1.19, 10.905 vs. 9.143 p = 0.027). Conclusions: These results suggest a measurable separation within atypical agents of efficacy versus tolerability agents by impact on total healthcare cost.
Presenting Author details: [email protected] 3811 Ohara St, 15213 Pittsburgh, United States, Tel.: +1 412 624 2211; fax: +1 412 246 5520. Background: Published cost-effectiveness analyses of atypical antipsychotic treatments for bipolar disorder are limited primarily due to lack of head to head studies. Our objective was to develop a model framework using published efficacy, adverse event and cost data for comparing cost-effectiveness of atypical antipsychotics and other standard treatments for bipolar I disorder in the United States. Methods: A cost-effectiveness model was developed using a Markov approach. Patients with acute mania/mixed episodes enter the model on monotherapy, but may switch to adjunctive therapy at any point after the first cycle. The time horizon was 1 year, with 3-week transition cycles. Overall costs estimated in the model included those for medications, inpatient and outpatient care, laboratory procedures, and treatment of adverse events. Effectiveness measures included number of hospital days, number of relapses and number of successfully treated patients. Example calculations were performed comparing ziprasidone with quetiapine (the most commonly used atypical antipsychotic). Results: Treatment with ziprasidone was not inferior to treatment with quetiapine. The model estimated annual costs of $37,362 for ziprasidone and $38,752 for quetiapine. The slightly lower annual costs with ziprasidone were primarily due to an estimate for ziprasidone compared to quetiapine of fewer hospital days (26.7 vs. 27.5 days), fewer relapses (0.810 vs. 0.936) and more successfully treated patients (0.884 vs. 0.881) in the base case analysis. Discussion: Data limitations make head-to-head comparisons between various treatments for bipolar disorder difficult. Similar to other therapeutic areas, this modeling effort may assist with medical decision making in treatment of bipolar disorder. doi:10.1016/j.schres.2007.12.092
Reference:
26 – REMISSION IN PATIENTS WITH SCHIZOPHRENIA TREATED WITH RISPERIDONE LONG-ACTING INJECTION (RLAI)
[1] Davis, J.M., 2006. The choice of drugs for schizophrenia. N Engl J Med. 354, 518–520.
J. Peuskens 1, M. Povey2, J. Van Der Veken 3, A. Jacobs 4.
doi:10.1016/j.schres.2007.12.091
1 Universitair Psychiatrisch Centrum, KU Leuven Campus UC St. Jozef Kortenberg, Belgium 2 SGS Biopharma, Wavre, Belgium
43
[1] Davis, J.M., 2006. The choice of drugs for schizophrenia. N Engl J Med. 354, 518–520.
25 – DEVELOPMENT OF A COST-EFFECTIVENESS MODEL FOR EVALUATING TREATMENT OF ACUTE MANIA/MIXED MANIA IN BIPOLAR I DISORDER
doi:10.1016/j.schres.2007.12.090
A. Fagiolini 1, J. Mauskopf 2, M.R. Wilson 2, J. Harnett 3, K.N. Sanders 3, C. Kremer 3.
Reference:
1
University of Pittsburgh, Pittsburgh, PA, USA RTI Health Solutions, Research Triangle Park, NC, USA 3 Pfizer Inc., New York, NY, USA 2
24 – DIRECT HEALTHCARE COSTS AFTER INITIATION OF ORAL ANTIPSYCHOTIC TREATMENT FOR SCHIZOPHRENIA: EFFICACY VERSUS TOLERABILITY J. Diels 1, K. Trakas 2, D. Nicholl 3, G. Nuyts 3. 1 Health Economics, Johnson and Johnson Pharmaceutical Services, Beerse, Belgium 2 Health Economics, Janssen-Ortho, Toronto, Canada 3 Health Economics, Johnson Pharmaceutical Services, Raritan, USA
Presenting Author details: [email protected] Turnhoutseweg 30, B-2340 Beerse, Belgium, Tel.: +32 14 603443; fax: +32 14 605425. Background: Variations in efficacy and tolerability profiles between atypical antipsychotics were hypothesized to lead to differences in direct healthcare costs in the management of schizophrenia. This analysis tested the difference between two groups of agents: those rated as more highly effective [1], olanzapine and risperidone, versus those with potential higher tolerability, aripiprazole, quetiapine and ziprasidone. Methods: Pharmetrics, a large US outpatient insurance claims database with regionally representative coverage, was analyzed for patients diagnosed with schizophrenia (ICD-9-CM code) initiating a new antipsychotic treatment (Jan 02 and Mar 05). Total medical costs, including all inpatient and outpatient costs related to the treatment of schizophrenia were examined in the year following the initiation of the treatment. Costs were assessed for each drug individually and for: (i) risperidone or olanzapine and (ii) aripiprazole, quetiapine or ziprasidone and examined using generalized gamma regression (GLM). All analyses were carried out on an intent-to-treat population and adjusted for potential confounders. Results: 2261 patients initiated on risperidone (54%) or olanzapine (46%) and 2571 patients initiated on aripiprazole (35%), quetiapine (40%) or ziprasidone (25%) met inclusion criteria. After adjustment for differences, the cost of overall health care was significantly higher in the patient group initiated with aripiprazole, quetiapine or ziprasidone compared to patients initiated on risperidone or olanzapine (GLM coefficient 1.13, 19.641 vs. 17.402, p b 0.0001). Higher inpatient costs were the main cost driver for differences between groups (GLM coefficient 1.19, 10.905 vs. 9.143 p = 0.027). Conclusions: These results suggest a measurable separation within atypical agents of efficacy versus tolerability agents by impact on total healthcare cost.
Presenting Author details: [email protected] 3811 Ohara St, 15213 Pittsburgh, United States, Tel.: +1 412 624 2211; fax: +1 412 246 5520. Background: Published cost-effectiveness analyses of atypical antipsychotic treatments for bipolar disorder are limited primarily due to lack of head to head studies. Our objective was to develop a model framework using published efficacy, adverse event and cost data for comparing cost-effectiveness of atypical antipsychotics and other standard treatments for bipolar I disorder in the United States. Methods: A cost-effectiveness model was developed using a Markov approach. Patients with acute mania/mixed episodes enter the model on monotherapy, but may switch to adjunctive therapy at any point after the first cycle. The time horizon was 1 year, with 3-week transition cycles. Overall costs estimated in the model included those for medications, inpatient and outpatient care, laboratory procedures, and treatment of adverse events. Effectiveness measures included number of hospital days, number of relapses and number of successfully treated patients. Example calculations were performed comparing ziprasidone with quetiapine (the most commonly used atypical antipsychotic). Results: Treatment with ziprasidone was not inferior to treatment with quetiapine. The model estimated annual costs of $37,362 for ziprasidone and $38,752 for quetiapine. The slightly lower annual costs with ziprasidone were primarily due to an estimate for ziprasidone compared to quetiapine of fewer hospital days (26.7 vs. 27.5 days), fewer relapses (0.810 vs. 0.936) and more successfully treated patients (0.884 vs. 0.881) in the base case analysis. Discussion: Data limitations make head-to-head comparisons between various treatments for bipolar disorder difficult. Similar to other therapeutic areas, this modeling effort may assist with medical decision making in treatment of bipolar disorder. doi:10.1016/j.schres.2007.12.092
Reference:
26 – REMISSION IN PATIENTS WITH SCHIZOPHRENIA TREATED WITH RISPERIDONE LONG-ACTING INJECTION (RLAI)
[1] Davis, J.M., 2006. The choice of drugs for schizophrenia. N Engl J Med. 354, 518–520.
J. Peuskens 1, M. Povey2, J. Van Der Veken 3, A. Jacobs 4.
doi:10.1016/j.schres.2007.12.091
1 Universitair Psychiatrisch Centrum, KU Leuven Campus UC St. Jozef Kortenberg, Belgium 2 SGS Biopharma, Wavre, Belgium