OBJECTIVES

Schizophrenia is a chronic, disabling mental disorder. Medication nonadherence is a major limiting factor in schizophrenia treatment. Paliperidone is an atypical antipsychotic that is available in 1-month and 3-month injectable formulations. The cost-effectiveness of paliperidone 3-month versus 1-month is unknown. This study evaluates the cost-effectiveness of paliperidone palmitate 3-month (PP3M) injection compared to paliperidone palmitate 1-month (PP1M) injection for adults with schizophrenia in the United States.

METHODS

A payer perspective decision analysis model for a one-year maintenance period of treatment with PP3M vs. PP1M was constructed. Effectiveness was assessed using the relapse-free percentage. One-year treatment cost and cost estimates of relapse and treatment discontinuation were used to estimate the incremental cost-effectiveness ratio (ICER) of PP3M vs. PP1M.

RESULTS

Based on the double-blind, noninferiority study of PP3M vs. PP1M, effectiveness of PP3M was higher than PP1M (91.2% vs 90%) and the estimated annual total cost of PP3M was lower than PP1M ($14,929 vs $18,097), which resulted in the ICER declined by $2,640. When considering the annual treatment costs of PP3M vs. PP1M (($16,410 vs $21,022), the ICER declined by $3,843. The cost-effectiveness analysis demonstrated that PP3M dominated PP1M. PP3M is more cost-effective compared to PP1M.

CONCLUSIONS

For schizophrenic patients who are eligible for treatment with long-acting injectable paliperidone, a 3-month formulation is more cost-effective than a 1-month formulation.