Cost-utility analysis of cariprazine compared to risperidone among patients with negative symptoms of schizophrenia

Abstract

ObjectivesThe aim was to assess the cost-effectiveness of cariprazine compared to second-generation antipsychotics in the treatment of schizophrenia for patients with negative symptoms in Hungary. MethodsTo assess the cost-effectiveness of cariprazine, a deterministic 8-health state Markov cohort model was built. The analysis was performed from a third-party payer perspective. Data were gathered from relevant sources of the scientific literature and public databases. Unit costs were based on tariffs of the National Health Insurance Fund Management. Key assumptions on treatment pathways and resource utilization were supported by experts to reflect clinical practice. These assumptions include the option of therapy switching, and selection of a 2-year time horizon. Deterministic and probabilistic sensitivity analyses were also conducted, together with scenario analyses. ResultsThe use of cariprazine resulted in 1.45 Quality-Adjusted Life Years (QALY) per patient, and a total cost of 3340 Euros per patient over a time horizon of 2 years. The use of risperidone resulted in 1.40 QALY/patient, and a total cost of 1896 Euros per patient. The incremental cost-effectiveness ratio (ICER) of the comparison between cariprazine and risperidone is therefore 28,897 Euros/QALY. The sensitivity analyses and the scenario analysis confirmed the robustness of the base-case results. ConclusionsCariprazine compared to risperidone in the treatment of schizophrenia for patients with negative symptoms provides additional health gain at acceptable costs according to the willingness to pay threshold in Hungary. The findings of the analysis were proven to be robust in the scenario analyses and sensitivity analyses.