title: Cost-Minimisation Analysis of Paliperidone Palmitate Long-Acting Treatment versus Risperidone Long-Acting Treatment for Schizophrenia in Spain.
abstract: OBJECTIVE
  Long-acting formulations for paliperidone (PPLAT) and risperidone (RLAT) are effective second-generation antipsychotics. This study aimed to compare treatment costs between PPLAT and RLAT in schizophrenia patients.
  
  
  METHODS
  A cost-minimization analysis was performed from the perspective of the Spanish National Healthcare System (NHS), in line with the approach accepted by the Scottish Medicine Consortium evaluation. Only direct health costs (€, 2015) were included, i.e. medication (including oral antipsychotic drug supplementation), hospitalization and cost of administration in the community. Two time horizons were used: 1 year (to compare initiation treatment) and 2 years (to compare maintenance treatment). Base-case considered the following assumptions: setting for treatment initiation (50 % hospital and 50 % community); 50 % of patients initiating from a long-acting treatment and 50 % from an oral antipsychotic; no reduction in the length of stay. One-way sensitivity analyses (SA) were performed.
  
  
  RESULTS
  The estimated costs/patient were €7698 (PPLAT) and €8168 (RLAT) for the first year, and €4314 (PPLAT) and €5003 (RLAT) for the second year. Cost savings related to PPLAT therapy were €470 and €689 for first and second year, respectively. SA results confirmed the robustness of the model results, even in the most conservative scenarios: (1) if 100 % of patients initiate treatment in hospital, the savings could be €454 per patient; (2) if 100 % of patients initiate treatment from an oral antipsychotic, the savings could be €277 per patient/year; and (3) if PPLAT could not reduce the length of stay by approximately one-third, as some studies indicate, the savings could be €470 per patient/year.
  
  
  CONCLUSIONS
  The use of PPLAT instead of RLAT could be a cost-saving strategy for the Spanish NHS.
authors.affiliation: Hospital Universitario Infanta Leonor, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Quintero
authors.affiliation: Pharmacoeconomics & Outcomes Research Iberia, Pº Joaquín Rodrigo 4I, Pozuelo de Alarcón, 28224, Madrid, Spain. ioyaguez@porib.com.
authors.forename: Itziar
authors.initials: I
authors.lastname: Oyagüez
authors.affiliation: Janssen-Cilag, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.affiliation: Janssen-Cilag, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cuervo-Arango
authors.affiliation: Janssen-Cilag, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: García
authors.affiliation: Pharmacoeconomics & Outcomes Research Iberia, Pº Joaquín Rodrigo 4I, Pozuelo de Alarcón, 28224, Madrid, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Casado
mesh_terms: D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D003363:Cost Control; D017046:Cost Savings; D003692:Delayed-Action Preparations; D016527:Drug Costs; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D018803:Models, Economic; D000068882:Paliperidone Palmitate / Q000191:economics* / Q000627:therapeutic use*; D018967:Risperidone / Q000191:economics* / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*; D013030:Spain
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018967:Risperidone; D000068882:Paliperidone Palmitate