Health Economic Research Institute, Sun Yat-sen University , Guangzhou, China.
Expert Rev Pharmacoecon Outcomes Res. 2020 Oct;20(5):549-557. doi: 10.1080/14737167.2020.1807331. Epub 2020 Sep 23.
Orally disintegrating tablet (ODT) formulation of antipsychotics is one of the innovative drug delivery systems developed to improve medication adherence. We aimed to evaluate the cost-effectiveness of aripiprazole ODT vs. aripiprazole standard oral tablet (SOT), as well as olanzapine SOT in China.
We developed a discrete event simulation model from government payers' perspective. On the entry, 100,000 patients in each group were simulated for relapse, adverse events, changing adherence level, medication discontinuation, switching or quitting in response to three different medication adherence levels. The model projected quality adjusted life years (QALYs) and treatment costs over a 1-year time horizon. Parameter uncertainties were assessed through sensitivity analyses.
The QALYs per patient over 1-year treatment with aripiprazole ODT, aripiprazole SOT, or olanzapine SOT, were 0.7282, 0.7112, and 0.7218, respectively. The corresponding costs were $1,423, $2,215, and $1,493. In both comparisons, aripiprazole ODT was dominant. Compared with aripiprazole SOT and olanzapine SOT, the likelihood of aripiprazole ODT being cost-effective was 99.2% and 69.2%, respectively, using 3 times per capita GDP per QALY as willingness-to-pay threshold.
The aripiprazole ODT is associated with more QALYs at lower costs compared with both aripiprazole SOT and olanzapine SOT in treating schizophrenia in China.
口服崩解片（ODT）是一种创新的药物传递系统，旨在提高药物依从性。我们旨在评估阿立哌唑 ODT 与阿立哌唑标准口服片剂（SOT）以及奥氮平 SOT 在我国的成本效益。
我们从政府支付者的角度开发了一个离散事件模拟模型。在进入时，模拟每个组中的 100,000 名患者在三种不同的药物依从性水平下出现复发、不良事件、改变依从性水平、停药、换药或停药。该模型预测了 1 年时间内的质量调整生命年（QALYs）和治疗成本。通过敏感性分析评估参数不确定性。
在 1 年的阿立哌唑 ODT、阿立哌唑 SOT 或奥氮平 SOT 治疗中，每位患者的 QALYs 分别为 0.7282、0.7112 和 0.7218。相应的成本分别为 1,423 美元、2,215 美元和 1,493 美元。在这两种比较中，阿立哌唑 ODT 都是主导的。与阿立哌唑 SOT 和奥氮平 SOT 相比，使用 3 倍人均 GDP 每 QALY 作为支付意愿阈值，阿立哌唑 ODT 的成本效益比分别为 99.2%和 69.2%。
在治疗中国精神分裂症方面，与阿立哌唑 SOT 和奥氮平 SOT 相比，阿立哌唑 ODT 具有更高的 QALYs 和更低的成本。
