Estimated medical cost reductions for paliperidone palmitate vs placebo in a
randomized, double-blind relapse-prevention trial of patients with
schizoaffective disorder.
Author(s): Joshi K(1), Lin J, Lingohr-Smith M, Fu DJ.
Affiliation(s): Author information:
(1)Janssen Scientific Affairs, Health Economics and Outcomes Research ,
Titusville, NJ , USA.
Publication date & source: 2015, J Med Econ. ,
OBJECTIVE: The objective of this economic model was to estimate the difference in
medical costs among patients treated with paliperidone palmitate once-monthly
injectable antipsychotic (PP1M) vs placebo, based on clinical event rates
reported in the 15-month randomized, double-blind, placebo-controlled,
parallel-group study of paliperidone palmitate evaluating time to relapse in
subjects with schizoaffective disorder.
RESEARCH DESIGN AND METHODS: Rates of psychotic, depressive, and/or manic
relapses and serious and non-serious treatment-emergent adverse events (TEAEs)
were obtained from the long-term paliperidone palmitate vs placebo relapse
prevention study. The total annual medical cost for a relapse from a US payer
perspective was obtained from published literature and the costs for serious and
non-serious TEAEs were based on Common Procedure Terminology codes. Total annual
medical cost differences for patients treated with PP1M vs placebo were then
estimated. Additionally, one-way and Monte Carlo sensitivity analyses were
conducted.
RESULTS: Lower rates of relapse (-18.3%) and serious TEAEs (-3.9%) were
associated with use of PP1M vs placebo as reported in the long-term paliperidone
palmitate vs placebo relapse prevention study. As a result of the reduction in
these clinical event rates, the total annual medical cost was reduced by $7140
per patient treated with PP1M vs placebo. One-way sensitivity analysis showed
that variations in relapse rates had the greatest impact on the estimated medical
cost differences (range: -$9786, -$4670). Of the 10,000 random cycles of Monte
Carlo simulations, 100% showed a medical cost difference <$0 (reduction) for
patients using PPIM vs placebo. The average total annual medical differences per
patient were -$8321 for PP1M monotherapy and -$6031 for PPIM adjunctive therapy.
CONCLUSIONS: Use of PP1M for treatment of patients with schizoaffective disorder
was associated with a significantly lower rate of relapse and a reduction in
medical costs compared to placebo. Further evaluation in the real-world setting
is warranted.
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