Cost-Minimization Analysis of Aripiprazole 2-Month Ready-to-Use vs. Other Long-Acting Injectable Antipsychotics: Evidence From Ontario
Author(s)
Khalid Lakhdari, MBA, MSc1, Vincent Touchette, MSc2, Karam Diaby, BSc, MSc, PhD3, Yagyesh Kanoria, PhD4.
1MS. MBA., Otsuka Pharma, Saint-laurent, QC, Canada, 2Lundbeck Canada Inc., Saint-Laurent, QC, Canada, 3Otsuka, Princeton, NJ, USA, 4Otsuka Pharma, Otsuka Pharma, NJ, USA.
1MS. MBA., Otsuka Pharma, Saint-laurent, QC, Canada, 2Lundbeck Canada Inc., Saint-Laurent, QC, Canada, 3Otsuka, Princeton, NJ, USA, 4Otsuka Pharma, Otsuka Pharma, NJ, USA.
OBJECTIVES: Background: Schizophrenia is a chronic psychiatric disorder associated with recurrent relapses, functional decline, and significant healthcare costs. Long-acting injectable (LAI) antipsychotics improve adherence and reduce relapse rates. Aripiprazole 2-month ready-to-use (Ari 2MRTU) is a newly approved LAI administered once every two months, designed to reduce injection burden while maintaining efficacy. Pharmacokinetic bridging data demonstrates comparable exposure to aripiprazole once-monthly (AOM) with prolonged postdose protection.Objective: To evaluate the economic impact on the Ontario Drug Benefit (ODB) program of funding Ari 2MRTU by comparing annual treatment costs with existing reimbursed LAI antipsychotics for maintenance therapy in adults diagnosed with schizophrenia
METHODS: Methods: A cost-minimization model was developed from the ODB perspective over a 1-year time horizon, assuming therapeutic equivalence among comparators. Direct medical costs (Canadian $), including drug acquisition, initiation, and administration, were sourced from ODB formulary data, public fee schedules, and literature. Ari 2MRTU was modeled using three initiation scenarios: (1) switch from AOM (56%), (2) one-injection start from oral aripiprazole (32.6%), and (3) two-injection start (11.4%), based on Canadian prescribing patterns (Cite data source, e,g, IQVIA). Comparators (AOM, risperidone LAI, paliperidone palmitate oncemonthly [PP1M], and three-monthly [PP3M]) were evaluated per label dosing. One-way and probabilistic sensitivity analyses assessed input uncertainty.
RESULTS: Results: Annual per-patient costs were: Ari 2MRTU $6,053; AOM $6,721; PP1M $8,930; PP3M $7,095; risperidone $9,018. Ari 2MRTU was associated with savings of $667 vs AOM, $1,042 vs PP3M, $2,877 vs PP1M, and $2,965 vs risperidone LAI. Savings stemmed primarily from fewer injections and lower administration costs. Sensitivity analyses confirmed the robustness of Ari 2MRTU’s cost advantage across variations in initiation pathway distributions and administration settings
CONCLUSIONS: Conclusion: These results demonstrate that Ari 2MRTU may deliver cost savings for maintenance treatment of schizophrenia when compared to other LAIs, and this was acrossdifferent initiation scenarios and care settings
METHODS: Methods: A cost-minimization model was developed from the ODB perspective over a 1-year time horizon, assuming therapeutic equivalence among comparators. Direct medical costs (Canadian $), including drug acquisition, initiation, and administration, were sourced from ODB formulary data, public fee schedules, and literature. Ari 2MRTU was modeled using three initiation scenarios: (1) switch from AOM (56%), (2) one-injection start from oral aripiprazole (32.6%), and (3) two-injection start (11.4%), based on Canadian prescribing patterns (Cite data source, e,g, IQVIA). Comparators (AOM, risperidone LAI, paliperidone palmitate oncemonthly [PP1M], and three-monthly [PP3M]) were evaluated per label dosing. One-way and probabilistic sensitivity analyses assessed input uncertainty.
RESULTS: Results: Annual per-patient costs were: Ari 2MRTU $6,053; AOM $6,721; PP1M $8,930; PP3M $7,095; risperidone $9,018. Ari 2MRTU was associated with savings of $667 vs AOM, $1,042 vs PP3M, $2,877 vs PP1M, and $2,965 vs risperidone LAI. Savings stemmed primarily from fewer injections and lower administration costs. Sensitivity analyses confirmed the robustness of Ari 2MRTU’s cost advantage across variations in initiation pathway distributions and administration settings
CONCLUSIONS: Conclusion: These results demonstrate that Ari 2MRTU may deliver cost savings for maintenance treatment of schizophrenia when compared to other LAIs, and this was acrossdifferent initiation scenarios and care settings
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE283
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Disease
Mental Health (including addition)