title: Cost-effectiveness simulation analysis of schizophrenia at the Instituto Mexicano del Seguro Social: Assessment of typical and atypical antipsychotics.
abstract: BACKGROUND
  Estimation of the economic costs of schizophrenia is a fundamental tool for a better understanding of the magnitude of this health problem. The aim of this study was to estimate the costs and effectiveness of five antipsychotic treatments (ziprasidone, olanzapine, risperidone, haloperidol and clozapine), which are included in the national formulary at the Instituto Mexicano del Seguro Social, through a simulation model.
  
  
  METHODS
  Type of economic evaluation: complete economic evaluation of cost-effectiveness.
  
  
  METHODS
  direct medical costs.
  
  
  METHODS
  1 year. Effectiveness measure: number of months free of psychotic symptoms.
  
  
  METHODS
  to estimate cost-effectiveness, a Markov model was constructed and a Monte Carlo simulation was carried out.
  
  
  RESULTS
  Effectiveness: the results of the Markov model showed that the antipsychotic with the highest number months free of psychotic symptoms was ziprasidone (mean 9.2 months). The median annual costs for patients using ziprasidone included in the hypothetical cohort was 194,766.6 Mexican pesos (MXP) (95% CI, 26,515.6-363,017.6 MXP), with an exchange rate of 1 € = 17.36 MXP. The highest costs in the probabilistic analysis were estimated for clozapine treatment (260,236.9 MXP).
  
  
  CONCLUSIONS
  Through a probabilistic analysis, ziprasidone showed the lowest costs and the highest number of months free of psychotic symptoms and was also the most costeffective antipsychotic observed in acceptability curves and net monetary benefits.
authors.affiliation: Unidad de Investigación en Economía de la Salud, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Mould-Quevedo
authors.forename: Iris
authors.initials: I
authors.lastname: Contreras-Hernández
authors.forename: Wáscar
authors.initials: W
authors.lastname: Verduzco
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Mejía-Aranguré
authors.forename: Juan
authors.initials: J
authors.lastname: Garduño-Espinosa