OBJECTIVES: to conduct a comparative pharmacoeconomic analysis of atypical antipsychotics for the treatment of schizophrenia – sertindole (SRT) versus quetiapine (QTP) and paliperidone (PAL).

METHODS: the primary outcomes for analysis were relapse and rehospitalization rates. Using the odds ratio (OR) of prehospitalization we calculated the related risk (RR) for three drugs. The cost of the annual drug therapy of schizophrenia in the outpatient setting, costs of hospital readmission and total costs were calculate. One-way sensitivity analysis was performed on 7 scenarios. Willingness to pay threshold (WTP) for Russian health care system was estimated at €26,383 (1648924 RUB), exchange rate mean in 2017 - €1 = 62.5 RUB.

RESULTS: the drug cost for annual therapy was the lowest for SRT – €1,550 (96856 RUB) – by 6% and 45% less than for QTP and PAL respectively. The RR of rehospitalization was 2.0% for PAL, 2.13% for SRT and 16.24% for QTP, so the cost for rehospitalisation was 7 times less for SRT versus QTP and only by 6.5% greater than for PAL. Therefore SRT therapy was the most cost saving by total cost – 13.8% less vs QTP and 31% versus PAL. Cost-effectiveness ratio (CER) for 1 patient treated without rehospitalization was €1,608 (100472 RUB) for SRT, €2,180 (136226 RUB) for QTP. SRT has higher CER versus PAL, but incremental cost-effectiveness ratio (ICER) for PAL more than 20 times higher than WTP (ICER= €532,542 (33 283 846 RUB). The most influential variable in the sensitivity analysis was dosage regimen.

CONCLUSIONS: SRT is the most cost-effective treatment versus QTP (CER less than CER QTP) and versus PAL ( SRT has insignificant deferens in treatment effectiveness -0,13%, but will be more cost saving treatment, ICER for PAL more than 20 times higher than Russian WTP threshold).