BazEkon - Biblioteka Główna Uniwersytetu Ekonomicznego w Krakowie

BazEkon home page

Meny główne

Hemels Michiel E. H. (Janssen Cilag, Birkerød, Denmark), Einarson Thomas R. (University of Toronto, Toronto, ON, Canada), Zilbershtein Roman (Pivina Consulting Inc., Mississauga, ON, Canada), Schubert Agata (Janssen, Warsaw, Poland), Skrzekowska-Baran Iwona (Janssen, Warsaw, Poland), Van Impe Kristel (Janssen, Neuss, Germany)
Cost-Effectiveness of Injectable Atypical Long-Acting Antipsychotics for Chronic Schizophrenia in Poland
Journal of Health Policy and Outcomes Research, 2013, nr 2, s. 50-55, rys., tab., bibliogr. 44 poz.
Słowa kluczowe
Finansowanie ochrony zdrowia, Ochrona zdrowia, Leki, Drzewo decyzyjne
Health care financing, Health care protection, Drugs, Decision tree
Objective: In order to determine the cost-effectiveness of paliperidone palmitate (PP-LAI), a long-acting injectable formulation, indicated for once-monthly injections as antipsychotic therapy, it was compared with risperidone, a long-acting, injectable (RLAI) and biweekly agent, administered for treatment of chronic schizophrenia in Poland, as perceived from the perspective of the National Health Fund (NHF). Methods: We adapted a 1-year decision tree model to the Polish healthcare system with literature-derived and clinical expert inputs. The compared drugs included PP-LAI, a new treatment option of antipsychotic therapy, and RLAI, the established treatment for Polish patients. Clinical rates were derived from published trials. Model outputs included expected cost per patient, as well as the rates of hospitalization, emergency room visits, days free of symptoms and quality-adjusted life-years (QALYs). One-way sensitivity analyses were applied to major inputs. All the inputs were also simultaneously varied in probabilistic sensitivity analyses. Results: Despite its higher acquisition cost, PP-LAI demonstrated a lower expected cost per treated patient. PP-LAI was associated with 0.824 QALYS, 323 days with stable disease and 44.6% hospitalization. RIS-LAI had 0.817 QALY, 317 stable days and 51.3% hospitalization. PP-LAI dominated RIS-LAI in the base case and in 55.0% of 10,000 simulations, and was cost-effective in 76.6%. However, the cost-effectiveness was sensitive, being lost with modest increases for PP-LAI or decreases for compared drugs with respect to their prices, relapse and adherence rates. Because it is injected monthly as opposed to biweekly, PP-LAI saves caregiver time as it is administered monthly, as opposed to the biweekly regimen. Conclusions: From the viewpoint of the National Health Fund of Poland, when compared with RLAI, PP-LAI is a cost-effective drug with potential to reduce healthcare expenses. (original abstract)
Pełny tekst
  1. Poland Demographics Profile 2012: Population. Available from:; Central Statistical Office; [Accessed: 2013-10-03]
  2. NHS Plan for report 2012. Available from:; [Accessed: 2013-10-03]
  3. Tandon R., Keshavan MS., Nasrallah HA. Schizophrenia, "just the facts" what we know in 2008. 2. Epidemiology and etiology. Schizophr Res 2008; 102: 1-18
  4. Rössler W., Salize HJ., van Os J., Riecher-Rössler A. Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 2005; 15: 399-409
  5. Knapp M., Mangalore R., Simon J. The global costs of schizophrenia. Schizophr Bull 2004; 30: 279-93
  6. Weiden PJ., Kozma C., Grogg A., Locklear J. Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv 2004; 55: 886-91
  7. Nasrallah H. The case for long-acting antipsychotic agents in the post-CATIE era. Acta Psychiatr Scand 2007; 115:260-7. Am J Psychiatry 2003; 160: 1125-32
  8. Kane J., Eerdekens M., Lindenmayer J-P., Keith S., Lesem M., Karcher K. Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry 2003; 160: 1125-32
  9. Kostrzewska K., Lis J., Glasek M., Rys P., Wladysiuk M., Plisko R. Cost-utility of amisulpride compared with first generation antipsychotics in treatment of schizophrenia in Poland. Value Health 2011; 14: A292
  10. Faluta T., Rdzanek M., Pierzgalska K., Wrobel B. The economic and social consequences of schizophrenia treatment with seroquel XR (quetiapine prolonged release tablets) in Poland: Analysis of the impact on the health care system. Value Health 2-11; 14: A289-A290
  11. Walczak J., Stelmachowski J., Obrzut G., Nogas G. Cost-utility analysis (CUA) of sertindole in the treatment of schizophrenia in Poland in general population of schizophrenic patients and population of patients intolerant to at least one other antipsychotic agent: A five-year markov model. Value Health 2010; 13: A453
  12. Walczak J., Augustynska J., Soltys E., Nogas G. Budget impact analysis of sertindole in the treatrment of schizophrenia in Poland. Value Health 2010; 13: A446-A447
  13. Wilk D., Rutkowski J., Dziewiatka M., Lis J., Glasek M., Plisko R. Budget impact analysis of amisulpride in treatment of schizophrenia in Poland. Value Health 2010; 13: A447
  14. Einarson TR., Geitona M., Chaidemenos A. et al. Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece. Ann Gen Psychiatry 2012 Jul 2; 11(1): 18
  15. Reimbursement list. Available from:; [Accessed: 2013-10-03]
  16. Poland Inflation rate (consumer prices). Available from:; [Accessed: 2012-11-20]
  17. Briggs A., Wild D., Lees M. et al. Impact of schizophrenia and schizophrenia treatment-related adverse events on quality of life: direct utility elicitation. Health Qual Life Outcomes 2008; 6:105
  18. Cummins C., Stevens A., Kisely S. The use of olanzapine as a first and second choice treatment in schizophrenia. Birmigham, UK: Department of Public Health & Epidemiology, University of Birmingham. A West Midlands Development and Evaluation Committee Report; 1998
  19. Lenert L., Sturley A., Rapaport M. et al. Public preferences for health states with schizophrenia and a mapping function to estimate utilities from positive and negative symptom scale scores. Schiz Res 2004; 71: 155-65
  20. Oh P., Lanctôt K., Mittmann N. et al. Cost-utility of risperidone compared with standard conventional antipsychotics in chronic schizophrenia. J Med Econ 2001; 4: 137-56
  21. Cost-effectiveness threshold information. Availablefrom:; [Accessed: 2013-10-04]
  22. European Medicines Agency. Xeplion® summary of product characteristics. Available from:; [Accessed: 2012-11-20]
  23. Svarstad BL., Shireman TI., Sweeney JK. Using drug claims data to assess the relationship of medication adherence with hospitalization and costs. Psychiatr Serv 2001; 52: 805-11
  24. Ascher-Svanum H., Faries DE., Zhu B., Ernst FR., Swartz MS., Swanson JW. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry 2006; 67: 453-60
  25. Rymaszewska J., Mazurek J. The social and occupational functioning of outpatients from mental health services. Adv Clin Exp Med 2012; 21: 215-23
  26. Rymaszewska J., Jarosz-Nowak J., Kiejna A. et al. Social disability in different mental disorders. Eur Psychiatry 2007; 22: 160-6
  27. Vevera J., Hubbard A., Veselý A., Papezová H. Violent behaviour in schizophrenia. Retrospective study of four independent samples from Prague, 1949 to 2000. Br J Psychiatry 2005; 187: 426-30
  28. Bo S., Abu-Akel A., Kongerslev M., Haahr UH., Simonsen E. Risk factors for violence among patients with schizophrenia. Clin Psychol Rev 2011; 31: 711-26
  29. All Wales Medicines Strategy Group. Final appraisal report: Olanzapine depot (ZypAdhera®), Lilly UK. Advice No: 1510 - October 2010. Available from:; [Accessed: 2012-11-20]
  30. Farahati F., Boucher M., Williams R., Williams R., Herrmann N., Silverman M. et al. Atypical antipsychotic monotherapy for schizophrenia: clinical review and economic evaluation of first year of treatment [Technology report number 91]. Ottawa: Canadian Agency for Drugs and Technologies in Heath 2007
  31. Fleischhacker WW., Gopal S., Lane R. et al. A randomized trial of paliperidone palmitate and risperidone long-acting injectable in schizophrenia. Int J Neurospychopharmacol 2011; Jul: 1-12
  32. Gopal S., Vijapurkar U., Lim P., Morozova M., Eerdekens M., Hough D. A 52-week open-label study of the safety and tolerability of paliperidone palmitate in patients with schizophrenia. J Psychopharmacol 2010; 25: 685-97
  33. European Medicines Agency. Xeplion® summary of product characteristics. Available from:; [Accessed: 2012-11-20]
  34. Gopal S., Hough D., Xu H., et al. Efficacy and safety of paliperidone palmitate in adult patients with acutely symptomatic schizophrenia: a randomized, double-blind, placebo-controlled, dose-response study. Int Clin Psychopharmacol 2010; 25: 247-56
  35. Hough D., Lindenmayer J-P., Gopal S. et al. Safety and tolerability of deltoid and gluteal injections of paliperidone palmitate in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 1022-31
  36. Nasrallah HA., Gopal S., Gassmann-Mayer C. et al. A controlled, evidence-based trial of paliperidone palmitate, a long-acting injectable antipsychotic, in schizophrenia. Neuropsychopharmacology 2010; 35: 2072-82
  37. Pandina GJ., Lindenmayer J-P., Lull JM. et al. A randomized, placebo-controlled study to assess the efficacy and safety of 3 doses of paliperidone palmitate in adults with acutely exacerbated schizophrenia. J Clin Psychiatry 2010; 30: 235-44
  38. Pandina GJ., Lane R., Gopal S. et al. A double-blind study of paliperidone palmitate and risperidone long-acting injectable in adults with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35: 218-26
  39. Fleischhacker W., Eerdekens M., Karcher K. et al. Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. J Clin Psychiatry 2003; 64: 1250-7
  40. Kissling W., Heres S., Lloyd K. et al. Direct transition to long-acting risperidone - analysis of long-term efficacy. J Psychopharmacol 2005; 19: 15-21
  41. Lasser R., Bossie C., Gharabawi G., Baldessarini R. Clinical improvement in 336 stable chronically psychotic patients changed from oral to long-acting risperidone: a 12-month open trial. Int J Neuropsychopharmacol 2005; 8: 427-38
  42. Lee M., Ko Y., Lee S. et al. Long-term treatment with long-acting risperidone in Korean patients with schizophrenia. Hum Psychopharmacol 2006; 21: 399-407
  43. Olivares J., Rodrigues-Morales A., Diels J. et al. Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: Results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR). Eur Psychiatry 2009; 24: 287-96
  44. Chue P., Eerdekens M., Augustyns I. et al. Comparative efficacy and safety of long-acting risperidone and risperidone oral tablets. Eur Neuropsychopharmacol 2005; 15: 111-7
  45. Eerdekens M., Van Hove I., Remmerie B., Mannaert E. Pharmacokinetics and tolerability of long-acting risperidone in schizophrenia. Schizophr Res 2004; 70: 91-100
  46. Kane J., Eerdekens M., Lindenmayer J-P., Keith S., Lesem M., Karcher K. Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry 2003; 160: 1125-32
Cytowane przez
Udostępnij na Facebooku Udostępnij na Twitterze Udostępnij na Google+ Udostępnij na Pinterest Udostępnij na LinkedIn Wyślij znajomemu