PMH20 - Real-World Budget impact analysis of atypical long-acting Anti-Psychotics in Finland

Abstract

The long-acting injectable aripiprazole once-monthly 400 mg (AOM 400) has been approved for treatment of schizophrenia in Finland since November 2013. Other atypical anti-psychotics, risperidone, paliperidone and olanzapine are also available as long-acting injectable formulations. A mixed treatment comparison has demonstrated that AOM 400 is at least as efficacious as other atypical long-acting anti-psychotics (ALAIs). However, cost of administration and drug (treatment cost) vary among the ALAIs. This analysis aims to investigate the total treatment costs of ALAIs using real-world data in Finland. A one-year time horizon budget impact analysis was conducted to compare the treatment costs of ALAIs in Finland. The real-world doses were calculated using sales data. One of the ALAIs (olanzapine) can be given in intervals of 2 or 4 weeks using the 300 mg strength. Half of the patients were assumed treated with the 300 mg dose every 2 weeks, the other half every 4 weeks. Prices for ALAIs were obtained from the official national price list. The cost of administration for AOM 400, paliperidone-LAI and risperidone-LAI was based on the cost of a short nurse visit (30 minutes) to a psychiatry outpatient clinic. The cost of administration of olanzapine-LAI was based on the cost of a longer visit (120-180 minutes), as the product information recommends monitoring for three hours after injection. The expected cost for drug and administration per patient, per year, for AOM 400 is 5158 EUR. The expected yearly costs per patient for drug and administration for paliperidone-LAI, risperidone-LAI and olanzapine-LAI are 6021 EUR, 6706 EUR and 11646 EUR respectively. In a budget impact analysis, using the method, data and assumptions described, AOM 400 is expected to be cost saving, in the real-world setting, in terms of cost of drug and administration, compared to other ALAIs available in Finland.