Mesones-Peral Jesús E, Gurillo-Muñoz Pedro, Sánchez-Sicilia Mari Paz, Miller Adam, Griñant-Fernández Alejandra
Servicio de Psiquiatría, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España; Centro de Salud Mental de La Mata, Torrevieja, Alicante, España.
Hospital de la Marina Baixa, Villajoyosa, Alicante, España.
Rev Psiquiatr Salud Ment. 2017 Jan-Mar;10(1):33-37. doi: 10.1016/j.rpsm.2016.01.011. Epub 2016 Apr 1.
Prevent hospitalizations in psychotic disorders is an important aim, so long-acting antipsychotic is a good option that can control better the correct adherence. Moreover, in the current economic context pharmacoeconomic studies are necessary. We estimate the effect in prevention of paliperidone palmitate long-acting injection (PP-LAI) and calculate the economic cost in the 12 months preceding the start of treatment with PP-LAI and 12 months later.
Mirror image study of 71 outpatients diagnosed with psychotic disorders and treated with PP-LAI. In a first analysis, we measured along one year: number of hospitalizations/year, number of hospitalization in days, number of emergency assists/year and if there is antipsychotics associated to long-acting treatment. After this phase, we applied Fees Act of Valencia for economic analysis and estimate of the cost per hospitalization (€ 5,640.41) and hospital emergency (€ 187.61).
After one year of treatment with PP-LAI (mean dose=130.65mg/month), we obtained greater numbers in assistance variables: total hospitalizations decrease, 78.8% (P=.009); shortening in hospitalization days, 89.4% (P=.009); abridgement of number of emergency assists, 79.1% (P=.002); decrease of rate of antipsychotics associated to long-acting treatment, 21% (P<.0001); increase in monotherapy, 53.8% (P<.0001). Therefore, after 12 months of treatment with PP-LAI we obtained a reduction in inpatient spending (savings of € 175,766.54) and increased spending on antipsychotics 32% (equivalent to € 151,126.92).
PP-LAI can be an effective therapy for the treatment of patients with severe psychotic disorders: improves symptomatic stability and can prevent hospitalizations with cost-effective symptom control.
预防精神障碍患者住院是一个重要目标，长效抗精神病药物是一个能更好地控制正确依从性的良好选择。此外，在当前经济背景下，药物经济学研究很有必要。我们评估棕榈酸帕利哌酮长效注射剂（PP-LAI）在预防方面的效果，并计算开始使用PP-LAI治疗前12个月及之后12个月的经济成本。
对71例诊断为精神障碍并接受PP-LAI治疗的门诊患者进行镜像研究。在首次分析中，我们在一年时间里测量：每年住院次数、住院天数、每年急诊次数以及是否有与长效治疗相关的抗精神病药物。在此阶段之后，我们应用瓦伦西亚收费法案进行经济分析，并估算每次住院成本（5640.41欧元）和医院急诊成本（187.61欧元）。
使用PP-LAI治疗一年后（平均剂量 = 130.65毫克/月），我们在辅助变量方面取得了更好的结果：住院总数减少，78.8%（P = 0.009）；住院天数缩短，89.4%（P = 0.009）；急诊次数减少，79.1%（P = 0.002）；与长效治疗相关的抗精神病药物使用率降低，21%（P < 0.0001）；单一疗法增加，53.8%（P < 0.0001）。因此，使用PP-LAI治疗12个月后，我们降低了住院支出（节省175766.54欧元），抗精神病药物支出增加了32%（相当于增加151126.92欧元）。
PP-LAI可能是治疗重度精神障碍患者的有效疗法：可改善症状稳定性，并能通过具有成本效益的症状控制预防住院。
