TY - JOUR

T1 - Cost-effectiveness of sertindole versus olanzapine or haloperidol

T2 - A comprehensive model

AU - Launois, Robert

AU - Von Der Schulenburg, Matthias Graf

AU - Knapp, Martin

AU - Toumi, Mondher

PY - 1998

Y1 - 1998

N2 - 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.

AB - 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.

KW - Cost-effectiveness model

KW - Haloperidol

KW - Olanzapine

KW - Schizophrenia

KW - Sertindole

UR - http://www.scopus.com/inward/record.url?scp=0032424212&partnerID=8YFLogxK

M3 - Review article

AN - SCOPUS:0032424212

VL - 2

SP - S79-S86

JO - International Journal of Psychiatry in Clinical Practice

JF - International Journal of Psychiatry in Clinical Practice

SN - 1365-1501

IS - SUPPL. 2

ER -