OBJECTIVES: We aimed to estimate the incremental budget impact (BI) of using RBP-7000 in adult acutely exacerbated schizophrenia patients.

METHODS: A prevalence-based BI model was developed from a US payer (direct costs only) perspective over a 3-year period. Effectiveness data (rates of remaining in relapse and adverse effects (AEs)) were indirectly compared for RBP-7000 and comparator LAIs: paliperidone palmitate, aripiprazole-monohydrate, aripiprazole-lauroxil, risperidone and olanzapine, using data from published phase-III trials. Drug and direct medical costs in USD (visits, tests, emergency room and hospitalizations) were obtained from RED BOOK Online (Average Wholesale Price) and 2018 TRUVEN MARKETSCAN Database (market share percentages).

RESULTS: In a hypothetical health plan of 1,000,000 members, 5,100 (0.51%) were diagnosed with acute schizophrenia and treated with LAIs with approximately 425 incident annual cases. The market share uptake of RBP-7000 was estimated at 2%, 6%, and 8%, yielding 102, 306 and 408 patients in years 1-3. During three years, the adoption of RBP-7000 was projected to decrease overall costs by $1.35M (relative BI of -0.17%, and per patient per month of -$0.037) versus status quo. Drug cost was estimated to decrease by $0.58M over three years including secondary therapy costs-savings, triggered by lower therapy switch for RBP-7000=35.37% versus other LAIs=38.06%-46.51%). Other cost-savings reducing the BI included medical costs triggered by lower rates of remaining in relapse (RBP-7000=11.03% vs other LAIs =11.94%-18.35%): $0.76M cost savings over three years, and AEs for RBP-7000 vs other LAIs ($0.01M cost savings over three years). Sensitivity analyses showed consistent cost saving patterns confirming the results.

CONCLUSIONS: Based on this BI model, RBP-7000 introduction may lead to cost-savings of $1.34M (-0.17%) over 3 years for a health plan of 1 million members. Since results could be affected by varying durations of the analyzed acute phase studies, additional studies addressing this potential confound are needed.