Cost of Relapse Management in Patients with Schizophrenia in Italy and Spain: Comparison Between Lurasidone and Quetiapi
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ORIGINAL RESEARCH ARTICLE
Cost of Relapse Management in Patients with Schizophrenia in Italy and Spain: Comparison Between Lurasidone and Quetiapine XR Umberto Restelli1,2 · Manuel García‑Goñi3 · Michal Lew‑Starowicz4,5 · Pawel Mierzejewski6 · Sofia Silvola1 · Jacqueline Mayoral‑van Son7 · Davide Croce1 · Paola Rocca8 · Benedicto Crespo‑Facorro7
© The Author(s) 2020
Abstract Background and Objective 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 firstline 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. Methods 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. 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%. Conclusions 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.
1 Background Schizophrenia is a low-prevalence mental disorder, having a global age-standardized prevalence of 0.28% (95% uncertainty interval 0.24–0.31) in 2016, which consists of 21 million people globally affected [1]. In Europe in 2011, the median prevalence of the pathology, which tends to become chronic, was 1.2%, consisting of 5 million persons [2]. The prevalence of this mental disorder is different among age Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40261-020-00944-0) contains supplementary material, which is available to authorized users. * Umberto Restelli [email protected] Extended author information available on the last page of the article
groups. This leads to a significant economic impact in terms of a
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