Economic evaluation of paliperidone ER for the treatment of schizophrenia in the context of Brazilian Public Health Care System

Abstract

OBJECTIVE: To perform a cost-effectiveness analysis of paliperidone ER versus olanzapine, quetiapine and ziprasidone, for the treatment of schizophrenia, from the Brazilian Public Healthcare System viewpoint. METHODS: A decision tree model was developed from the viewpoint of the Brazilian Public Healthcare System, using a 1 year time horizon. Published medical literature, unpublished clinical trials, public database information (DATASUS) and a clinical expert panel populated the model. The model includes only direct costs obtained from the Ambulatory and Hospital Information System and the Price Database of the Brazilian Ministry of Health. The primary clinical outcome was number of stable days. RESULTS: Long-term effectiveness (number of stable days in one year) of paliperidone ER (280) was similar to olanzapine (279) and better than ziprasidone (272) and quetiapine (267). Paliperidone ER was the treatment arm with lowest annual costs per patient (US$ 1.909), followed by ziprasidone (US$ 1.929), olanzapine (US$ 2.106) and quetiapine (US$ 2.362)1 . CONCLUSIONS: Paliperidone ER was cost-saving. Its incorporation may result in a better clinical evolution, reflected in less relapse days, and lower health care cost when compared to olanzapine, quetiapine and ziprasidone.