Diaby Vakaramoko, Pandey Shubhram, Sanogo Vassiki, Almutairi Reem Dhayan, Kanoria Yagyesh, Nag Soma S
Global Value and Real-World Evidence, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ.
Pharmacoevidence, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ.
J Manag Care Spec Pharm. 2025 Jan;31(1):60-67. doi: 10.18553/jmcp.2025.31.1.60.
Bipolar disorder is a severe recurrent, episodic psychiatric condition with a worldwide prevalence of approximately 1%, affecting more than 5 million adults in the United States in 2020. A subtype, bipolar I disorder (BP-I), which accounts for approximately one-quarter of cases, is associated with impairments in psychosocial functioning and quality of life. Recommended treatment options include daily oral, or long-acting injectable, antipsychotics, including the aripiprazole once every month formulation, which has been shown to improve adherence compared with oral treatments. A new formulation of aripiprazole for administration once every 2 months ready to use (Ari 2MRTU) has been shown to have similar efficacy to monthly treatment, with only 6 doses annually.
To estimate the financial impact of introducing the new formulation of aripiprazole as a treatment option for adults diagnosed with BP-I in the United States.
A cohort of eligible patients with BP-I was selected from a hypothetical US health plan of 1 million members, and the treatment costs modeled with a 3-year time horizon, in scenarios with or without the addition of Ari 2MRTU. Inputs into the model included user-definable estimates of the current and projected market share of the available antipsychotics, forecast uptake of aripiprazole new formulation, acquisition, initiation, and administration costs, hospitalization costs, time on treatment, and patient adherence. The budget impact was estimated as the difference in the annual cost for the total cohort for the current and new scenarios, the cost per member per month, and the cost per treated member per month. Deterministic sensitivity analyses were also conducted to examine the extent to which the model results were affected by variations in individual input parameters.
The total budget impact of introducing a formulation of Ari 2MRTU as maintenance monotherapy for treating a cohort of eligible patients with BP-I in the United States from a health plan of 1 million members was estimated to be $898,930 over 3 years, representing a per member per month cost saving of $0.025 and a per treated member per month cost saving of $2.43. The sensitivity analysis supports a modest reduction in budget, with the main driver being adherence with medication regimen.
The introduction of Ari 2MRTU as a maintenance treatment for adults with BP-I is expected to have a neutral effect on payer budgets in the United States and is a potentially favorable option for patients who prefer less frequent dosing.
双相情感障碍是一种严重的复发性发作性精神疾病，全球患病率约为1%，2020年在美国影响超过500万成年人。一种亚型，即双相I型障碍（BP-I），约占病例的四分之一，与心理社会功能和生活质量受损有关。推荐的治疗选择包括每日口服或长效注射用抗精神病药物，包括每月一次的阿立哌唑制剂，与口服治疗相比，已证明该制剂可提高依从性。一种每两个月给药一次的即用型阿立哌唑新制剂（Ari 2MRTU）已证明与每月治疗具有相似的疗效，每年只需6剂。
评估在美国将阿立哌唑新制剂作为诊断为BP-I的成年人的治疗选择所产生的财务影响。
从一个拥有100万成员的假设性美国健康计划中选取符合条件的BP-I患者队列，并在添加或不添加Ari 2MRTU的情况下，以3年时间范围对治疗成本进行建模。模型的输入包括对现有抗精神病药物当前和预计市场份额的用户可定义估计、阿立哌唑新制剂的预测采用情况、采购、起始和给药成本、住院成本、治疗时间和患者依从性。预算影响估计为当前和新情景下总队列年度成本的差异、每月每位成员的成本以及每月每位接受治疗成员的成本。还进行了确定性敏感性分析，以检查模型结果受各个输入参数变化影响的程度。
对于一个拥有100万成员的健康计划，在美国将Ari 2MRTU制剂作为维持单药疗法用于治疗符合条件的BP-I患者队列，估计3年的总预算影响为898,930美元，相当于每位成员每月节省成本0.025美元，每位接受治疗成员每月节省成本2.43美元。敏感性分析支持预算适度减少，主要驱动因素是药物治疗方案的依从性。
将Ari 2MRTU作为BP-I成年人的维持治疗引入，预计对美国支付方预算具有中性影响，对于更喜欢减少给药频率的患者而言是一个潜在的有利选择。
