TY  - JOUR
PY  - 2011//
TI  - Cost-effectiveness of olanzapine long-acting injection in the treatment of patients with schizophrenia in the United States: a micro-simulation economic decision model
JO  - Current medical research and opinion
A1  - Furiak, Nicolas M.
A1  - Ascher-Svanum, Haya
A1  - Klein, Robert W.
A1  - Smolen, Lee J.
A1  - Lawson, Anthony H.
A1  - Montgomery, William
A1  - Conley, Robert R.
SP  - 713
EP  - 730
VL  - 27
IS  - 4
N2  - OBJECTIVE: To compare, from the perspective of third-party payers in the United States health care system, the cost-effectiveness of olanzapine long-acting injection (LAI, depot) with alternative antipsychotic agents including risperidone-LAI, paliperidone-LAI, haloperidol-LAI, and oral olanzapine, in the treatment of patients with schizophrenia who have been non-adherent or partially adherent with oral antipsychotics.  RESEARCH DESIGN AND METHODS: A 1-year micro-simulation economic decision model was developed to simulate the dynamics of usual care of patients with schizophrenia who continue, discontinue, switch, or restart their medication. The model uses a range of clinical and cost parameters including adherence levels, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment discontinuation rates by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct health care costs. Published medical literature and a clinical expert panel were used to develop baseline model assumptions.  OUTCOME MEASURES: Key model outputs include annual total direct cost (US$) per treatment and incremental cost-effectiveness values per additional QALY gained.  RESULTS: Model results found that the olanzapine-LAI treatment strategy was more effective (greater QALYs) and less costly than risperidone-LAI, paliperidone-LAI, and haloperidol-LAI. In addition, olanzapine-LAI was both more effective and more costly, with an estimated incremental cost/QALY of $26,824 compared to oral olanzapine. The base-case and multiple sensitivity analyses found olanzapine-LAI to remain within acceptable cost-effective ranges (<$50,000) in terms of incremental cost/QALY gained.  CONCLUSIONS: This micro-simulation model finds the olanzapine-LAI treatment strategy to result in better effectiveness and to be a cost-effective alternative compared to oral olanzapine and the LAI formulations of risperidone, paliperidone, and haloperidol in the treatment of non-adherent and partially adherent patients with schizophrenia in the United States. A key limitation is the assumption how LAI therapies compare to oral counterparts due to sparse head-to-head data. Further research is needed to verify baseline assumptions.<p /> <p>Language: en</p>
LA  - en
SN  - 0300-7995
UR  - http://dx.doi.org/10.1185/03007995.2011.554533
ID  - ref1
ER  -