OBJECTIVES: Currently, negative symptoms are regarded as a core aspect of schizophrenia and considered the major contributor to low function levels and deterioration in most patients with schizophrenia. Cariprazine is the first drug enabling psychiatrists to optimally treat schizophrenia patients with negative symptoms. The main objective of this research was to assess the cost-effectiveness of cariprazine compared to risperidone, in the treatment of schizophrenia patients with negative symptoms in Sweden and Denmark

METHODS: A deterministic 8-health state Markov cohort model was built, to support the cost-utility analyses that were performed from a third-party payer perspective in both countries. Data were gathered from the scientific literature and public databases, supported by clinical experts in each country. Cost data was gathered from local sources, to ensure that the results were relevant in the particular countries.

RESULTS: The use of cariprazine resulted in 1.45 QALY/patient over a time horizon of two years. The use of the comparator (risperidone) resulted in 1.40 QALY/patient in both countries. Cariprazine was associated with higher drug costs than risperidone. However, due to the estimated savings in other healthcare costs, especially regarding hospitalization costs, the cariprazine arm resulted in a lower amount of total healthcare costs. Therefore, cariprazine was considered to be a dominant therapy providing more health benefits for a lower amount of total costs.

CONCLUSIONS: It was demonstrated in the model that cariprazine provides more health gain to patients with negative symptoms of schizophrenia compared to risperidone. Though cariprazine therapy requires additional costs in comparison with the current risperidone treatment, due to the estimated savings in hospitalization costs in the two countries, it was considered to be not only cost-effective, but a dominant therapy as well both in Sweden and Denmark. The robustness of the results of the base-case analyses was confirmed by several scenario analyses and sensitivity analyses.