Presentation (CTI)

OBJECTIVES: Poor adherence to oral antipsychotics (OAPs) is a key driver of schizophrenia relapse risk. Long-acting injectable antipsychotics (LAIs) may enhance treatment continuity, thus reducing the risk of relapsing. This analysis was conducted to investigate economic sustainability of a 30 - 40% switch to LAIs favoured by availability of formulations with increasingly extended dosing intervals, such as 6-month paliperidone palmitate (PP6M), in UAE.
METHODS: This analysis assessed the 3-year budget impact of transitioning patients from OAPs to LAIs, from the United Arab Emirates (UAE) healthcare payer perspective. The current treatment mix, without PP6M, was compared with an alternative scenario in which its availability has a towing effect that increases overall LAI adoption. Patients were redistributed across strategies according to expected transitions from oral therapy to monthly LAIs and subsequently to longer-interval regimens, up to PP6M. Strategy-specific relapse rates were calculated from published meta-analytic estimates applied to locally elicited baseline hospitalization rates. Drug acquisition and hospitalizations were valued according to official local unit prices (2026 AED).
RESULTS: Compared with OAPs, monthly, three-monthly, and PP6M LAIs generated annual savings of 8%, 26%, and 50%, corresponding to 3, 10, and 20 K AED/patient/year, respectively, as higher pharmaceutical costs (7-11 K AED/patient/year) were offset by fewer hospitalizations. Assuming 7,700 additional patients (~30% of total switched to LAIs, with almost 50% of LAI users progressing to PP6M), the expected 3-year net saving was nearly AED 200 million: 20 M in year 1, 60 M in year 2, and 120 M in year 3. In year 1, 660 patients received PP6M after transitions from OAPs, monthly or three-monthly LAIs; uptake increased in years 2 and 3, totalling 5,500 PP6M initiations over 3 years.
CONCLUSIONS: In the UAE healthcare setting, transitioning schizophrenia patients from OAPs to LAIs, including PP6M, generates substantial budget saving, further supporting long interval LAIs as optimal strategy.