Abstract
ObjectiveExamine cost-driving factors of schizophrenia in Germany for patients prior- and post-switch from an oral antipsychotic therapy to aripiprazole-depot and perform a budget impact analysis (BIA) referring to the context of German health care.MethodsA single-armed, retrospective, non-interventional pre-post comparison study with 132 patients to compare the total psychiatric hospitalization rates and the associated costs of both, the treatment with oral antipsychotics and aripiprazole-depot. The BIA was performed to compare both treatment periods with respect to health-related costs. A subsequent univariate sensitivity analysis examined the robustness of the results.ResultsAfter switching the treatment to aripiprazole-depot, the total psychiatric hospitalization rates for the 6-month treatment period were significantly (p < 0.001) lower (14%) compared to the hospitalization rates when treated with oral antipsychotics (55.1%). 18.2% of the patients reported to be employed, with 29.2% having work incapacities. The mean number of schizophrenia episodes was 2.58 episodes per patient during the oral-antipsychotic treatment compared to 0.41 episodes per patient during the aripiprazole-depot phase (p < 0.001). The treatment with aripiprazole-depot also significantly reduced the mean number of hospitalizations per patient (0.63 to 0.16, p < 0.001) and the mean number of hospitalized days (27.39 to 5.56, p < 0.001) compared to the oral antipsychotic treatment. Additionally a significant reduction of the mean stay in day-clinics and psychiatric institute ambulances (PIAs) was observed (46.13 days to 7.29 days, p < 0.01).Treatment of a patient suffering from schizophrenia with oral antipsychotics produced costs of 9935.38€ (direct costs: 9498.36 €), while aripiprazole-depot generated costs of 4557.56€ (direct costs: 4449.83 €) per patient for a one-year observation period. This resulted in total costs of 6,517,606,265.43€ for the oral antipsychotic treatment and 2,989,756,603.05€ for aripiprazole-depot treatment from the perspective of the German health care system. The results remained robust during sensitivity analysis, with aripiprazole-depot being the more cost-effective strategy.ConclusionsThe results suggest that aripiprazole-depot treatment for schizophrenia patients has major potential in terms of cost savings for the German statutory health insurance.
Highlights
Schizophrenia is estimated to affect 24 million individuals worldwide (656,000 - 738,0001 [1] in Germany considering a prevalence rate between 0.8% and 0.9% for patients between 18 and 65 years [2])
Study design and observation group This study was carried out as a single armed, non-interventional pre-post comparison study with a subsequent budget impact analysis (BIA) to assess hospitalization rates in patients with schizophrenia treated with oral antipsychotics followed by a treatment with aripiprazole-depot in a community setting in Germany
The required sample size was estimated at n = 116 to provide 80% power to detect a statistically significant difference of 11% between the hospitalization rate during the aripiprazole-depot treatment period (Phase B) and a recently published hospitalization rate for patients being treated with oral antipsychotics (38.1%) from the mentioned study [11]
Summary
Study design and observation group This study was carried out as a single armed, non-interventional pre-post comparison study with a subsequent BIA to assess hospitalization rates in patients with schizophrenia treated with oral antipsychotics followed by a treatment with aripiprazole-depot in a community setting in Germany. The required sample size was estimated at n = 116 to provide 80% power to detect a statistically significant difference of 11% between the hospitalization rate during the aripiprazole-depot treatment period (Phase B) and a recently published hospitalization rate for patients being treated with oral antipsychotics (38.1%) from the mentioned study [11]. Statistical analysis Comparisons between hospitalization rates during the retrospective oral anti-psychotic treatment period (months 1–6) and the aripiprazole-depot treatment period (months 7–12) were assessed using Wilcoxon signed rank tests with a statistical significance at an alpha level of 0.05 (two-sided) after using Kolgomorov-Smirnov tests to check the observed empirical distributions for normality. The analysis form is increasingly required in national reimbursement procedures and can be used for resource or budget planning [15] In this investigation, a BIA was performed to estimate the annual budget impact of two different treatment options for schizophrenia. The direct costs were evaluated separately in order to avoid misunderstandings regarding the direct and indirect costs of schizophrenia
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
