Augusto Margarida, Greene Mallik, Touya Maëlys, Sweeney Samantha Min, Waters Heidi
PAREXEL International, London, UK.
Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA.
J Comp Eff Res. 2018 Jul;7(7):627-636. doi: 10.2217/cer-2018-0009. Epub 2018 Apr 25.
To estimate the budget impact (BI) of introducing aripiprazole once-monthly 400 mg/300 mg (AOM 400) in the maintenance monotherapy treatment of bipolar I disorder versus long-acting injectables, oral antipsychotics and best supportive care.
A BI model was developed from a US-payer perspective using treatment-related, hospitalization and adverse event management cost estimates for a hypothetical 1,000,000-member health plan over a 5-year period.
Market share of AOM 400 was predicted to increase from 0.6% in Year 1 (current scenario) to 1.3% in Year 5 (predicted scenario), with predicted increases for paliperidone palmitate, asenapine and cariprazine. Treatment-related costs explained the BI increase, while adverse event and hospitalization costs were reduced. The per member per month incremental cost ranged from US$0.06 to US$0.26 in Years 1-5. The largest increases were predicted for paliperidone palmitate.
As market shares of atypical antipsychotics are predicted to increase, payers may wish to re-evaluate their use.
评估与长效注射剂、口服抗精神病药物及最佳支持性治疗相比，在双相I型障碍维持单药治疗中引入每月一次400毫克/300毫克阿立哌唑（AOM 400）的预算影响（BI）。
从美国医保支付方的角度建立一个BI模型，使用一个假设的拥有100万成员的健康计划在5年期间与治疗相关、住院及不良事件管理的成本估算。
预计AOM 400的市场份额将从第1年的0.6%（当前情况）增至第5年的1.3%（预测情况），同时预计帕利哌酮棕榈酸酯、阿塞那平及卡立普唑的市场份额也会增加。与治疗相关的成本解释了BI的增加，而不良事件及住院成本则有所降低。在第1 - 5年，每位成员每月的增量成本在0.06美元至0.26美元之间。预计帕利哌酮棕榈酸酯的增幅最大。
由于预计非典型抗精神病药物的市场份额会增加，医保支付方可能希望重新评估其使用情况。
