COST ANALYSIS MODEL FOR THE TREATMENT OF ACUTE AGITATION AMONG PATIENTS WITH SCHIZOPHRENIA IN CHINA
Author(s)
Yeh Y1, Yu X2, Zhang C3, Hao W4, Du F5, Liu D6, Yang L6, Gao X7
1Pharmerit International, Newton, MA, USA, 2Department of Psychiatry, Peking University Sixth Hospital, Beijing, China, 3Psychiatry Department, the First Specialized Hospital of Harbin, Harbin, China, 4Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, China, 5Pharmerit (Shanghai) Company Limited, Shanghai, China, 6Pfizer Investment Co., Ltd., Beijing, China, 7Pharmerit International, Bethesda, MD, USA
OBJECTIVES : To assess the healthcare resource utilization and cost associated with the inpatient treatment of short-acting intramuscular (IM) ziprasidone, oral risperidone + oral benzodiazepine, oral olanzapine, short-acting IM haloperidol, and electroconvulsive therapy (ECT) for the management of acute agitation among patients with schizophrenia in China from a hospital’s perspective. METHODS : Cost measures included hospital room and board, antipsychotics, ECT, and medications for the management of extrapyramidal symptoms (EPS). Input for standard antipsychotic regimens and unit cost were obtained from literature. Hospital length of stay (LOS), utilization of ECT, and incidence of EPS were derived from the literature and supplemented/validated with a survey of 9 psychiatrists in China. Cost was presented in 2017 RMB (¥). RESULTS : Based on the survey, the average (range) estimated LOS was 29 (14-42) days with ziprasidone, 33 (15-60) days with risperidone + benzodiazepine, 32 (15-50) days with olanzapine, 35 (25-50) days with haloperidol, and 29 (12-42) days with ECT. The cost of antipsychotics was ¥1,261 with ziprasidone, ¥137 with risperidone + benzodiazepine, ¥913 with olanzapine, ¥210 with haloperidol; ECT treatment cost ¥1,585. The base-case analysis suggested that higher antipsychotic cost with ziprasidone was offset by savings with shorter LOS. Total costs including all the cost measures during the inpatient stay was the lowest with ziprasidone among all regimens (¥11,157 with ziprasidone, ¥11,406 with ECT, ¥11,422 with risperidone plus benzodiazepine, ¥11,711 with olanzapine, and ¥11,923 with haloperidol). The cost of antipsychotics and ECT accounted for 1.2% to 13.9% of the total cost. Varying LOS between the lower and upper bounds of the 95% confidence interval, total cost was comparable between these regimens. CONCLUSIONS : Overall, the cost for the management of acute agitation was similar between IM ziprasidone and other antipsychotics. Compared to other antipsychotics, higher medication cost of IM ziprasidone can be offset by savings with shorter hospital stay.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PMH28
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Mental Health