Cost-effectiveness of asenapine in the treatment of bipolar disorder in Canada

BMC Psychiatry

Maud Beillat³  Dominique Gilbert¹  Karine Mathurin²  Catherine Beauchemin²  Jean Lachaine² 

[1] Market Access and Health Outcomes, Lundbeck Canada Inc., Montreal, Quebec, Canada;Faculty of Pharmacy, University of Montreal, Station Centre-ville, PO Box 6128, H3C 3 J7 Montreal, Quebec, Canada;Health Economics and HTA, Lundbeck S.A.S., Issy-Les-Moulineaux, France

关键词: Olanzapine;    Cost-effectiveness;    Cost-utility;    Canada;    Antipsychotic;    Bipolar disorder;    Asenapine;   

Others  :  1123824
DOI  :  10.1186/1471-244X-14-16

 received in 2012-12-12, accepted in 2014-01-20,  发布年份 2014

【 摘 要 】

Background

Bipolar disorder (BPD) is prevalent and is associated with a significant economic burden. Asenapine, the first tetracyclic antipsychotic approved in Canada for the treatment of BPD, has shown a comparable efficacy profile to other atypical antipsychotics. In addition, it is associated with a favourable metabolic profile and minimal weight gain potential. This study aimed to assess the economic impact of asenapine compared to olanzapine in the treatment of BPD in Canada.

Methods

A decision tree combined with a Markov model was constructed to assess the cost-utility of asenapine compared with olanzapine. The decision tree takes into account the occurrence of extrapyramidal symptoms (EPS), the probability of switching to a different antipsychotic, and the probability of gaining weight. The Markov model takes into account long-term metabolic complications including diabetes, hypertension, coronary heart diseases (CHDs), and stroke. Analyses were conducted from both a Canadian Ministry of Health (MoH) and a societal perspective over a five-year time horizon with yearly cycles.

Results

In the treatment of BPD, asenapine is a dominant strategy over olanzapine from both a MoH and a societal perspective. In fact, asenapine is associated with lower costs and more quality-adjusted life years (QALYs). Results of the probabilistic sensitivity analysis indicated that asenapine remains a dominant strategy in 99.2% of the simulations, in both a MoH and a societal perspective, and this result is robust to the many deterministic sensitivity analyses performed.

Conclusions

This economic evaluation demonstrates that asenapine is a cost-effective strategy compared to olanzapine in the treatment of BPD in Canada.

【 授权许可】

   
2014 Lachaine et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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