Annals of General Psychiatry (Jul 2012)

Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece

  • Einarson Thomas R,
  • Geitona Maria,
  • Chaidemenos Alexandros,
  • Karpouza Vasiliki,
  • Mougiakos Theodoros,
  • Paterakis Periklis,
  • Ploumpidis Dimitrios,
  • Potamitis-Komis Dionyssios,
  • Zilbershtein Roman,
  • Vicente Colin,
  • Piwko Charles,
  • Kakkavas Panagiotis,
  • Paparouni Konstantina,
  • Jensen Rasmus C D,
  • Hemels Michiel E H

DOI
https://doi.org/10.1186/1744-859X-11-18
Journal volume & issue
Vol. 11, no. 1
p. 18

Abstract

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Abstract Background Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. Purpose To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. Methods A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). Results The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. Conclusions PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes.

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