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

BMC Psychiatry

Research Article

Jean Lachaine¹  Karine Mathurin¹  Catherine Beauchemin¹  Maud Beillat²  Dominique Gilbert³ 

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

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

DOI  :  10.1186/1471-244X-14-16

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

来源: Springer

【 摘 要 】

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

【 授权许可】

CC BY   
© Lachaine et al.; licensee BioMed Central Ltd. 2014