4 research outputs found
Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece
BACKGROUND: Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. PURPOSE: To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. METHODS: A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). RESULTS: The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. CONCLUSIONS: PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes
COMT and MTHFR polymorphisms interaction on cognition in schizophrenia: An exploratory study
The investigation of the catechol-O-methyltransferase (COMT-[rs4680])
and methylenetetrahydrofolate reductase (MTHFR-[rs1801133])
polymorphisms’ interaction might shed light into the pathogenetic
mechanisms of the cognitive dysfunction in schizophrenia. In an
exploratory study, we hypothesized that the MTHFR 677T allele which has
been related to a hypoactive MTHFR enzyme would augment the unfavorable
effects of COMT Val158 homozygosity which has been associated with COMT
enzyme hyperfunction. 90 schizophrenia patients and 55 healthy
volunteers were assessed on psychomotor speed, pattern and spatial
recognition memory (SRM), spatial working memory (SWM), attentional
flexibility and planning (Stockings of Cambridge-SOC). IQ scores in a
random subgroup of patients were also measured. A significant COMT x
MTHFR interaction on SWM (p = 0.048) and planning (p = 0.026) was
revealed in both groups. Among COMT-Val/Val participants, MTHFR-C/C made
more SWM errors (p = 0.033) and solved fewer SOC problems (p = 0.025)
than MTHFR-T carriers. In patients, there was a significant COMT x MTHFR
interaction on full scale IQ (p = 0.035): among COMT-Met carriers,
MTHFR-T carriers performed significantly worse than MTHFR-C/C (p =
0.021), which was driven by a COMT x MTHFR interaction involving
performance IQ(p = 0.047). In conclusion, COMT and MTHFR polymorphisms
interacted on cognition, suggesting that the MTHFR enzyme activity might
moderate the effects of the COMT enzyme. In contrast to our initial
hypothesis, the MTHFRT-allele attenuated the cognitive effects of COMT
Val homozygosity. In this preliminary study, we propose that
dopaminergic and intracellular methylation mechanisms could interact on
cognitive deficits in schizophrenia. (c) 2013 Elsevier Ireland Ltd. All
rights reserved
Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece
Abstract
Background
Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation.
Purpose
To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece.
Methods
A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs).
Results
The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI.
Conclusions
PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes
Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece
Abstract Background Patients having chronic schizophrenia with frequent relapses and hospitalizations represent a great challenge, both clinically and financially. Risperidone long-acting injection (RIS-LAI) has been the main LAI atypical antipsychotic treatment in Greece. Paliperidone palmitate (PP-LAI) has recently been approved. It is dosed monthly, as opposed to biweekly for RIS-LAI, but such advantages have not yet been analysed in terms of economic evaluation. Purpose To compare costs and outcomes of PP-LAI versus RIS-LAI in Greece. Methods A cost-utility analysis was performed using a previously validated decision tree to model clinical pathways and costs over 1 year for stable patients started on either medication. Rates were taken from the literature. A local expert panel provided feedback on treatment patterns. All direct costs incurred by the national healthcare system were obtained from the literature and standard price lists; all were inflated to 2011 costs. Patient outcomes analyzed included average days with stable disease, numbers of hospitalizations, emergency room visits, and quality-adjusted life-years (QALYs). Results The total annual healthcare cost with PP-LAI was €3529; patients experienced 325 days in remission and 0.840 QALY; 28% were hospitalized and 15% received emergency room treatment. With RIS-LAI, the cost was €3695, patients experienced 318.6 days in remission and 0.815 QALY; 33% were hospitalized and 17% received emergency room treatment. Thus, PP-LAI dominated RIS-LAI. Results were generally robust in sensitivity analyses with PP-LAI dominating in 74.6% of simulations. Results were sensitive to the price of PP-LAI. Conclusions PP-LAI appears to be a cost-effective option for treating chronic schizophrenia in Greece compared with RIS-LAI since it results in savings to the health care system along with better patient outcomes.</p