D'yakov I N, Zyryanov S K
Mechnikov Research Institute of Vaccines and Sera.
Moscow, Russia ,Pirogov Russian National Research Medical University, Ministry of Health, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(2):85-92. doi: 10.17116/jnevro20171172185-92.
To evaluate clinical and economic efficacy of schizophrenia treatment with three forms of paliperidone (peroral form, intramuscular injections once a month and once in three month).
Pharmacoeconomic analysis based on the results of earlier foreign randomized clinical studies on paliperidone in treatment of schizophrenia was carried out. Indirect comparison of different medication forms of paliperidone compared to placebo was performed. The analysis of costs was based on a Markov model built for the study. Two categories of costs: costs of pharmacological treatment with paliperidone and costs of disease exacerbation due to the violation of treatment regimen were considered. To assess pharmacoeconomic efficacy of paliperidone, a cost-benefit analysis with calculation of cost utility ratio (CUR) and incremental cost utility ratio (ICUR) was used.
In view of the influence on the budget, all forms of paliperidone have similar pharmacoeconomic efficacy with the advantage of prolonged release injectable (depot) forms that increase patient's adherence to treatment. As a result, CUR of injectable forms was lower compared to that of the peroral form by 11,1 and 46,3% of month and 3-month forms, respectively. ICUR for paliperidone used once in 3 month (trevicta) was more effective compared to paliperidone used monthly (xeplion). It has been concluded that paliperidone for prolonged release injections used once in 3 month is most pharmacoeconomically effective.
评估三种形式的帕利哌酮（口服制剂、每月一次和每三个月一次的肌肉注射制剂）治疗精神分裂症的临床和经济疗效。
基于先前国外关于帕利哌酮治疗精神分裂症的随机临床研究结果进行药物经济学分析。对帕利哌酮不同剂型与安慰剂进行间接比较。成本分析基于为该研究构建的马尔可夫模型。考虑两类成本：帕利哌酮药物治疗成本和因治疗方案中断导致的疾病加重成本。为评估帕利哌酮的药物经济学疗效，采用成本效益分析并计算成本效用比（CUR）和增量成本效用比（ICUR）。
鉴于对预算的影响，所有形式的帕利哌酮具有相似的药物经济学疗效，长效注射（储库）剂型具有优势，可提高患者的治疗依从性。结果，注射剂型的CUR分别比口服剂型低11.1%（每月剂型）和46.3%（每三个月剂型）。每三个月使用一次的帕利哌酮（trevicta）的ICUR比每月使用一次的帕利哌酮（xeplion）更有效。得出结论：每三个月使用一次的长效注射用帕利哌酮在药物经济学上最有效。
