Pharmacoeconomic comparison of aripiprazole once-monthly and paliperidone palmitate from a head-to-head clinical trial in schizophrenia: a US analysis

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Authors
Christophe Sapin, Ann Hartry, Siddhesh A Kamat, Maud Beillat, Ross A Baker, Anna Eramo

Article Type
Original Research

DOI
10.7573/dic.212301

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Abstract

Schizophrenia presents a substantial clinical and economic burden to the health-care system. In QUAlity of LIfe with AbiliFY Maintena (QUALIFY), a randomized head-to-head study of aripiprazole once-monthly 400 mg (AOM 400) compared with paliperidone palmitate (PP; 78–234 mg/mo), AOM 400 demonstrated greater improvement in health-related quality of life and functioning in patients with stable schizophrenia. The present analysis used health economics assessment data collected during the QUALIFY study to determine the direct medical and pharmacy costs and the cost-effectiveness associated with each treatment over 6 months. Compared with those receiving PP, patients receiving AOM 400 incurred significantly lower direct total costs ($8908±186 vs $9675±190, p=0.005) and treatment costs ($7967±113 vs $8706±116, p<0.001). Effectiveness results in the subset of patients included in the cost analyses were similar to the overall population: mean (95% CI) improvement in Heinrichs-Carpenter Quality of Life Scale total score was greater with AOM 400 (5.97 [3.87; 8.08]) compared with PP (2.85 [0.56; 5.08]). Likewise, Clinical Global Impression–Severity improved more in the AOM 400 group (–0.59 [–0.71; –0.47]) compared with PP group (–0.37 [–0.46; –0.27]). Therefore, the analysis of data from stabilized patients with schizophrenia in the QUALIFY study indicated that AOM 400 is associated with lower health-care costs and greater effectiveness compared with PP and thus represents the economically dominant strategy.

Keywords: aripiprazole once-monthly, paliperidone palmitate, schizophrenia, cost-effectiveness, long-acting injectable agents, second-generation antipsychotic, health economics, patient functioning.

Abbreviations: AOM 400, aripiprazole once-monthly 400 mg; BMI, body mass index; CGI-S, Clinical Global Impression– Severity; CI, confidence interval; FAS, full-analysis set; HEA, health economics assessment; IM, intramuscular; LAI, long-acting injectable; LSM, least squares mean; PP, paliperidone palmitate; QLS, Heinrichs-Carpenter Quality of Life Scale; QUALIFY, QUAlity of LIfe with AbiliFY Maintena; SD, standard deviation; SE, standard error; USD, US dollars; WoRQ, Work Readiness Questionnaire.

Citation: Sapin C, Hartry A, Kamat SA, Beillat M, Baker RA, Eramo A. Pharmacoeconomic comparison of aripiprazole once-monthly and paliperidone palmitate from a head-to-head clinical trial in schizophrenia: a US analysis. Drugs in Context 2016; 5: 212301. DOI: 10.7573/dic.212301

Disclosure and potential conflict of interest: Christophe Sapin and Maud Beillat are employees of Lundbeck SAS. Ann Hartry and Anna Eramo are employees of Lundbeck LLC. Siddhesh A. Kamat and Ross A. Baker are employees of Otsuka Pharmaceutical Development & Commercialization, Inc.

The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the author is available for download at: https://www.drugsincontext.com/wp-content/uploads/2016/09/dic.212301-COI.pdf.

Contributions: Christophe Sapin, Maud Beillat, Ann Hartry, and Siddhesh Kamat contributed to the conception and design of this study. Christophe Sapin and Maud Beillat contributed to the acquisition of data. Christophe Sapin and Ann Hartry performed statistical analyses. Siddhesh Kamat, Anna Eramo, and Ross Baker provided administrative, technical, or material support. All authors contributed to the analysis and interpretation of the data and to the writing, review, and revision of the manuscript.

Acknowledgments: Editorial assistance for preparation of the manuscript was provided by Vandana Sharma at C4 MedSolutions, LLC (Yardley, PA), a CHC Group company, and funded by Otsuka Pharmaceutical Development & Commercialization, Inc. and H. Lundbeck A/S.

Funding declaration: The study was supported by Otsuka Pharmaceutical Development & Commercialization, Inc. and H. Lundbeck A/S.

Trial registration: ClinicalTrials.gov, NCT01795547

Copyright: Copyright © 2016 Sapin C, Hartry A, Kamat SA, Beillat M, Baker RA, Eramo A. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2016 Sapin C, Hartry A, Kamat SA, Beillat M, Baker RA, Eramo A. http://dx.doi.org/10.7573/dic.212301. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 3.0.

Article URL: https://www.drugsincontext.com/pharmacoeconomic-comparison-of-aripiprazole-once-monthly-and-paliperidone-palmitate-from-a-head-to-head-clinical-trial-in-schizophrenia-a-us-analysis

Correspondence: Siddhesh A. Kamat, MS, MBA, Otsuka Pharmaceutical Development & Commercialization, Inc., 508 Carnegie Center Dr., Princeton, NJ, 08540 USA. siddhesh.kamat@otsuka-us.com

Provenance: Submitted, externally peer reviewed

Submitted: 1 August 2016; Peer review comments to author: 31 August 2016; Publication date: 23 September 2016

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