Center for Health Economics, Social and Health Care Management, University Carlo Cattaneo-LIUC, Corso Matteotti, 22, 21053, Castellanza, VA, Italy.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Clin Drug Investig. 2020 Sep;40(9):861-871. doi: 10.1007/s40261-020-00944-0.
Schizophrenia is a low-prevalence mental disorder with a global age-standardized prevalence of 21 million people (2016). Second-generation antipsychotics (lurasidone and quetiapine XR) are recommended as the first-line treatment for schizophrenia. It is interesting to investigate how the results of clinical studies translate into direct medical costs. The objective of this analysis was to assess the direct medical costs related to pharmaceutical treatments and the management of relapses in patients affected with schizophrenia treated with lurasidone (74 mg) vs quetiapine XR (300 mg) assuming the Italian and Spanish National Health Service perspective.
A health economic model was developed based on a previously published model. The analysis considered direct medical costs related to the pharmacological therapies and inpatient or outpatient management of relapses (direct medical costs referred to 2019). The probability of relapses and related costs were derived from two systematic reviews. A deterministic sensitivity analysis was implemented to test the robustness of the results.
The use of lurasidone (74 mg) compared with quetiapine XR (300 mg) would lead to a reduction in direct medical costs in Italy and Spain, with a lower cost per patient of - 163.7 € (- 9.0%) and - 327.2 € (- 22.7%), respectively. In detail, it would lead to an increase in the cost of therapy of + 53.8% and of + 30.5% in Italy and Spain, respectively, to a decrease in the cost of relapses with hospitalization of - 135.7%, and to an increase in the cost of relapses without hospitalization of + 24.5%.
The use of lurasidone (74 mg) for the treatment of patients affected with schizophrenia, compared with quetiapine XR (300 mg), would be a cost-saving strategy in the two contexts investigated assuming the National Health Service point of view.
精神分裂症是一种低患病率的精神障碍，全球年龄标准化患病率为 2100 万人（2016 年）。第二代抗精神病药（鲁拉西酮和富马酸喹硫平 XR）被推荐为精神分裂症的一线治疗药物。有趣的是，研究临床研究的结果如何转化为直接医疗成本。本分析的目的是评估与药物治疗相关的直接医疗成本以及接受鲁拉西酮（74mg）与富马酸喹硫平 XR（300mg）治疗的精神分裂症患者复发的管理费用，假设从意大利和西班牙国家卫生服务的角度来看。
基于先前发表的模型，开发了一种健康经济学模型。该分析考虑了与药物治疗和复发的住院或门诊管理相关的直接医疗成本（直接医疗成本参考 2019 年）。复发的概率和相关成本来自两项系统评价。实施确定性敏感性分析以测试结果的稳健性。
与富马酸喹硫平 XR（300mg）相比，使用鲁拉西酮（74mg）将导致意大利和西班牙的直接医疗成本降低，每位患者的成本分别降低-163.7 欧元（-9.0%）和-327.2 欧元（-22.7%）。具体而言，它将导致意大利和西班牙的治疗成本分别增加 53.8%和 30.5%，住院复发成本降低 135.7%，非住院复发成本增加 24.5%。
在假设国家卫生服务观点的情况下，与富马酸喹硫平 XR（300mg）相比，使用鲁拉西酮（74mg）治疗精神分裂症患者将是一种节省成本的策略。
