Kim Bo-Ra-Mi, Lee Tae-Jin, Lee Hye-Jae, Park Bo-Hyun, Yang Bong-Min
Graduate School of Public Health, Seoul National University, Seoul, South Korea.
Graduate School of Public Health, Seoul National University, Seoul, South Korea.
Value Health Reg Issues. 2012 May;1(1):59-65. doi: 10.1016/j.vhri.2012.03.015. Epub 2012 May 25.
This study assessed the cost-effectiveness of sertindole compared with existing atypical antipsychotics in the treatment of patients with schizophrenia in the South Korean setting.
A Markov model was developed to estimate the cost-effectiveness of sertindole compared with risperidone, olanzapine, and quetiapine with a cycle of 6 months on a 5-year time horizon. Effectiveness was defined as the length of time without relapse and quality-adjusted life-years. Parameter estimates including drug-induced adverse events, compliance rate, and relapse rate were based on published literature and clinical trial data. Resource utilization data were obtained from the 2010 National Health Insurance reimbursement data, and costs were estimated from the health care system's perspective. A discount rate of 5% was applied to both cost and effectiveness. One-way sensitivity analyses and probabilistic sensitivity analysis were carried out to check the robustness of the base-case analysis.
The length of time without relapse was 1.90 years for all study drugs. The estimated quality-adjusted life-years were 1.27 for sertindole, followed by quetiapine, risperidone, and olanzapine. Total costs were 10.51 million Korean won (KRW) for sertindole, 12.86 million KRW for olanzapine, 8.38 million KRW for risperidone, and 8.91 million KRW for quetiapine. The incremental cost-effectiveness ratios showed that sertindole was dominant only over olanzapine and was not cost-effective compared with risperidone and quetiapine. Various sensitivity analyses confirmed the results from the base-case analysis.
Sertindole may be considered a valuable treatment option for South Korean patients who have failed the therapy with other atypical antipsychotic agents.
本研究评估了在韩国环境下，与现有非典型抗精神病药物相比，舍吲哚治疗精神分裂症患者的成本效益。
建立了一个马尔可夫模型，以估计舍吲哚与利培酮、奥氮平和喹硫平相比的成本效益，周期为6个月，时间跨度为5年。有效性定义为无复发时间长度和质量调整生命年。包括药物引起的不良事件、依从率和复发率在内的参数估计基于已发表的文献和临床试验数据。资源利用数据来自2010年国家健康保险报销数据，成本从医疗保健系统的角度进行估计。成本和有效性均采用5%的贴现率。进行了单向敏感性分析和概率敏感性分析，以检验基础案例分析的稳健性。
所有研究药物的无复发时间长度均为1.90年。舍吲哚的估计质量调整生命年为1.27，其次是喹硫平、利培酮和奥氮平。舍吲哚的总成本为1051万韩元，奥氮平为1286万韩元，利培酮为838万韩元，喹硫平为891万韩元。增量成本效益比表明，舍吲哚仅优于奥氮平，与利培酮和喹硫平相比不具有成本效益。各种敏感性分析证实了基础案例分析的结果。
对于其他非典型抗精神病药物治疗失败的韩国患者，舍吲哚可被视为一种有价值的治疗选择。
