PMH40 - COST-MINIMISATION ANALYSIS OF SECOND GENERATION LONG ACTING INJECTABLES (RISPERIDONE , PALIPERIDONE, AND ARIPIPRAZOLE) FOR SCHIZOPHRENIA IN SPANISH MEDIUM-LONG TERM CARE PSYCHIATRIC UNITS

Abstract

A cost-minimization analysis was performed from the perspective of the Spanish National Healthcare System (NHS) on second generation long acting antipsychotic injectables (LAI) in medium-long term care inpatient clinical wards from 15 different hospitals. The objective was to identify the most cost-saving LAI in clinical practice. Inclusion criteria were to have a diagnostic of schizophrenia spectrum disorder, to have a stable treatment for at least three months and hospital stay longer than five months. We evaluate the real dosing plan used with LAI in a previous multicentric, transversal and observational study. Afterwards we used a cost-minimization analysis to compare what LAI option is the most cost-saving option. We only consider drug treatment cost and administration cost, once hospitalization cost has none variation between options treatments in medium-long term psychiatric care units. Statistics test, ANOVA, was applied to compare the mean annual cost between the different LAI: Bonferroni-adjusted post hoc test was performed when necessary. We evaluated 371 patients dosing schedules that help very much to make a real economical evaluation: monthly aripiprazole treatment year cost is 4204 euros (n=80, SD: 240,9), monthly paliperidone is 6190 euros (n=168, SD: 2711,8), three months paliperidone is 5082,3 euros (n=61, SD:1852,5) and two weeks risperidone is 7067,8 euros (n=62, SD:2458,8). Monthly aripiprazole has a significant difference in cost when compared with monthly paliperidone (-1986 euros; p<0,0001), and two weeks risperidone (-2863 euros; p<0,0001) but the difference between three months paliperidone is not statistically significant (-878,2 euros; p=0,12). Three months paliperidone has a significant difference in cost when compared monthly paliperidone (-1107,8 euros; p=0,006) and risperidone (-1985,6 euros; p<0,0001). Monthly paliperidone versus risperidone (-877,8; p=0,049). Monthly aripiprazole is a cost-saving option to reduce economic burden of schizophrenia treatment in this group of patients followed by three months paliperidone.