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Applied Health Economics and Health Policy

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01.10.2015 | Original Research Article

A Cost-effectiveness Analysis of Antipsychotics for Treatment of Schizophrenia in Uganda

verfasst von: Solomon J. Lubinga, Byamah B. Mutamba, Angelo Nganizi, Joseph B. Babigumira

Erschienen in: Applied Health Economics and Health Policy | Ausgabe 5/2015

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Abstract

Background

Reductions in prices following the expiry of patents on second-generation antipsychotics means that they could be made available to patients with schizophrenia in low-income countries. In this study we examine the cost effectiveness of antipsychotics for schizophrenia in Uganda.

Methods

We developed a decision-analytic 10-state Markov model to represent the clinical and treatment course of schizophrenia and the experience of the average patient within the Uganda healthcare system. The model was run for a base population of 25-years-old patients attending Butabika National Referral Mental Hospital, in annual cycles over a lifetime horizon. Parameters were derived from a primary chart abstraction study, a local community pharmacy survey, published literature, and expert opinion where necessary. We computed mean disability-adjusted life-years (DALYs) and costs (in US$ 2012) for each antipsychotic, incremental cost, and DALYs averted as well as incremental cost-effectiveness ratios (ICERs).

Results

In the base-case analysis, mean DALYs were highest with chlorpromazine (27.608), followed by haloperidol (27.563), while olanzapine (27.552) and risperidone had the lowest DALYs (27.557). Expected costs were highest with quetiapine (US$4943), and lowest with risperidone (US$4424). Compared to chlorpromazine, haloperidol was a dominant option (i.e. it was less costly and more effective); and risperidone was dominant over both haloperidol and quetiapine. The ICER comparing olanzapine to risperidone was US$5868 per DALY averted.

Conclusion

When choosing between first-generation antipsychotics, clinicians should consider haloperidol as the first-line agent for schizophrenia. However, overall, risperidone is a cost-saving strategy; policymakers should consider its addition to essential medicines lists for treatment of schizophrenia in Uganda.

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Titel: A Cost-effectiveness Analysis of Antipsychotics for Treatment of Schizophrenia in Uganda
verfasst von: Solomon J. Lubinga
Byamah B. Mutamba
Angelo Nganizi
Joseph B. Babigumira
Publikationsdatum: 01.10.2015
Verlag: Springer International Publishing
Erschienen in: Applied Health Economics and Health Policy / Ausgabe 5/2015
Print ISSN: 1175-5652
Elektronische ISSN: 1179-1896
DOI: https://doi.org/10.1007/s40258-015-0176-3

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

A Cost-effectiveness Analysis of Antipsychotics for Treatment of Schizophrenia in Uganda

Abstract

Background

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

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