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阿立哌唑每月一次与棕榈酸帕利哌酮每月一次治疗法国精神分裂症的成本效益分析

[Cost-effectiveness analysis of aripiprazole once-monthly versus paliperidone palmitate once-monthly in the treatment of schizophrenia in France].

作者信息

Gozlan G, Lecardeur L, Monfort A-S, Doz M, Ortiz I, Larroumets P, Lafuma A

机构信息

32, boulevard de Courcelles, 75017 Paris, France.

UMR 6232 CNRS, centre Esquirol, centre hospitalier universitaire de Caen, avenue Côte de Nacre, 14033 Caen cedex, France.

出版信息

Encephale. 2018 Dec;44(6):496-503. doi: 10.1016/j.encep.2018.10.001. Epub 2018 Oct 26.

Abstract

OBJECTIVE

The aim of the study was to estimate the cost-effectiveness ratio of aripiprazole once-monthly compared to once-monthly injectable paliperidone palmitate in the treatment of schizophrenia in France on the basis of results and data from the QUALIFY study.

METHODS

Consumed resources data measured with a dedicated questionnaire and results on the quality of life scales from the QUALIFY study were combined with French standard unit costs of each collected consumed resources during QUALIFY to estimate the cost-effectiveness ratios of the two products. Multivariate sensitivity analyses were performed to test the combined impact of the different assumptions.

RESULTS

Findings of the study showed greater efficacy on the quality of life (QLS) and psychiatric evaluation scales (CGI-S and CGI-I) observed in QUALIFY of aripiprazole compared with paliperidone palmitate. Findings also suggest a trend (P=0.0733) in the reduction of total costs linked to a statistical decrease (P<0,0001) in drug costs in the aripiprazole group. These findings are reinforced by the probabilistic sensitivity analyses.

CONCLUSION

Aripiprazole appeared to be more cost-effective than paliperidone palmitate in the French context. Limits of this study are mainly related with the duration of the clinical trial and to assumptions on the transposability of measured consumed resources in the international clinical trial to the French healthcare system.

摘要

目的

本研究旨在根据QUALIFY研究的结果和数据,评估在法国治疗精神分裂症时,每月一次的阿立哌唑与每月一次的注射用帕利哌酮棕榈酸酯相比的成本效益比。

方法

将通过专用问卷测量的消耗资源数据以及QUALIFY研究中生活质量量表的结果,与QUALIFY期间每种收集到的消耗资源的法国标准单位成本相结合,以估计两种产品的成本效益比。进行多变量敏感性分析以测试不同假设的综合影响。

结果

研究结果显示,与帕利哌酮棕榈酸酯相比,QUALIFY研究中观察到阿立哌唑在生活质量(QLS)和精神评估量表(CGI-S和CGI-I)方面具有更高的疗效。研究结果还表明,阿立哌唑组药物成本出现统计学下降(P<0.0001),总成本降低呈现一种趋势(P=0.0733)。概率敏感性分析进一步强化了这些结果。

结论

在法国的背景下,阿立哌唑似乎比帕利哌酮棕榈酸酯更具成本效益。本研究的局限性主要与临床试验的持续时间以及国际临床试验中测量的消耗资源向法国医疗保健系统的可转移性假设有关。

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