Cost-effectiveness of sertindole versus olanzapine or haloperidol

A comprehensive model

authored by

Robert Launois, Matthias Graf Von Der Schulenburg, Martin Knapp, Mondher Toumi

Abstract

The safety and efficacy of second generation antipsychotics relative to conventional treatment are well documented in schizophrenia, although their economic impact has not yet been evaluated. The aim of this study was to evaluate antipsychotics in normal practice using a 10-year costeffectiveness model based on a 6-month Markov cycle tree. The model incorporated three competing drug strategies (sertindole, olanzapine and haloperidol); five care management strategies, defined by place of residence (hospital, residential or private home) and intensity of care (intensive or mild); clinical events (extrapyramidal symptoms, sedation, weight gain, sexual dysfunction, and relapse); and direct medical costs associated with each. Adverse-event rates were estimated from integrated safety reports; compliance and relapse rates were obtained from meta-analysis of the literature. The model comprised 15 discrete health states; transition probabilities among these were derived from local patient cohorts. The model computed that the relative risks of relapse on haloperidol or olanzapine compared with sertindole are 1.4 and 1.2, respectively, corresponding to an additional 5.7 and 13.5 months without relapse over 10 years. Furthermore, in most scenarios, sertindole is self- financing because less time is spent in hospital and indeed shows modest net savings compared with these drugs. These results clearly show the cost- effectiveness of sertindole.

Organisation(s)

Center for Health Economics Research Hannover (CHERH)

External Organisation(s)

University of Paris Sorbonne North
London School of Economics and Political Science
H. Lundbeck A/S

Type

Review article

Journal

International Journal of Psychiatry in Clinical Practice

Volume

2

Pages

S79-S86

ISSN

1365-1501

Publication date

1998

Publication status

Published

Peer reviewed

Yes

ASJC Scopus subject areas

Psychiatry and Mental health

Sustainable Development Goals

SDG 3 - Good Health and Well-being

Electronic version(s)

https://www.researchgate.net/publication/288393800_Cost-effectiveness_of_sertindole_versus_olanzapine_or_haloperidol_A_comprehensive_model (Access: Unknown)