Cost-effectiveness of long-acting risperidone injection versus alternative atypical antipsychotic agents in patients with schizophrenia in China.
OBJECTIVE
To determine the most cost-effective strategy involving first-line treatment with long-acting risperidone, olanzapine, and quetiapine from the perspective of the Chinese health-care system.


METHODS
A decision analytical model was applied. The model used a time horizon of 2 years. The probabilities of treatment response of different agents and the relapse and hospitalization rates were estimated by a Delphi panel of 17 senior psychiatrists in China. The unit cost for each medical service was calculated from the price system database built by China National Development and Reform Commission and the medical resource utilization was estimated by the Delphi panel. The principal efficacy measure was the proportion of patients successfully treated. Various sensitivity analyses were carried out to test the robustness of the model.


RESULTS
The proportion of patients successfully treated over the 2-year period was 46.71% for long-acting risperidone, 39.93% for olanzapine, and 31.28% for quetiapine. The mean cost-effectiveness ratios were RMB189,427, RMB202,432, and RMB233,015 per successfully treated patient for long-acting risperidone, quetiapine and olanzapine, respectively. Results of the sensitivity analyses confirmed that the results were robust.


CONCLUSIONS
The results showed that long-acting risperidone is more cost-effective than olanzapine and quetiapine for patients with schizophrenia in long-term maintenance treatment.
Yang
Li
L
School of Public Health, Peking University Health Science Center, Beijing, China.
Li
Ming
M
Tao
Li-bo
LB
Zhang
Mingliang
M
Nicholl
M Deborah
MD
Dong
Peng
P
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000191:economics*; D001569:Benzodiazepines / Q000191:economics* / Q000627:therapeutic use; D002681:China; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D003987:Dibenzothiazepines / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular; D018803:Models, Economic; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000008:administration & dosage / Q000191:economics*; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine