Cost-effectiveness analysis of ziprasidone versus haloperidol in sequential intramuscular/oral treatment of exacerbation of schizophrenia: economic subanalysis of the ZIMO trial.

Title

Cost-effectiveness analysis of ziprasidone versus haloperidol in sequential intramuscular/oral treatment of exacerbation of schizophrenia: economic subanalysis of the ZIMO trial.

Creator

Canas F; Perez-Sola V; Diaz S; Rejas J; ZIMO Trial Collaborative Group

Publisher

Clinical Drug Investigation

Date

2007

Subject

Female; Humans; Male; Adult; Treatment Outcome; Drug Therapy; Research Design; Cost-Benefit Analysis; Cost of Illness; Spain; quality of life; Administration; Oral; IM; Injections; Intramuscular; Drug Costs; Haloperidol/ad [Administration & Dosage]; Combination; Hospital Costs; Antipsychotic Agents/ad [Administration & Dosage]; Antipsychotic Agents/ec [Economics]; Brief Psychiatric Rating Scale; Haloperidol/ec [Economics]; Length of Stay/ec [Economics]; Piperazines/ad [Administration & Dosage]; Piperazines/ec [Economics]; Schizophrenia/dt [Drug Therapy]; Schizophrenia/ec [Economics]; Thiazoles/ad [Administration & Dosage]; Thiazoles/ec [Economics]

Description

OBJECTIVE: This study aimed to assess the cost effectiveness of ziprasidone versus haloperidol in sequential intramuscular (IM)/oral treatment of patients with exacerbation of schizophrenia in Spain. METHODS: A cost-effectiveness analysis from the hospital perspective was performed. Length of stay, study medication and use of concomitant drugs were calculated using data from the ZIMO trial. The effectiveness of treatment was determined by the percentage of responders (reduction in baseline Brief Psychiatric Rating Scale [BPRS] negative symptoms subscale >or=30%). Economic assessment included estimation of mean (95% CI) total costs, cost per responder and the incremental cost-effectiveness ratio (ICER) per additional responder. The economic uncertainty level was controlled by resampling and calculation of cost-effectiveness acceptability curves. RESULTS: A total of 325 patients (ziprasidone n = 255, haloperidol n = 70) were included in this economic subanalysis. Ziprasidone showed a significantly higher responder rate compared with haloperidol (71% vs 56%, respectively; p = 0.023). Mean total costs were euro3582 (95% CI 3226, 3937) for ziprasidone and euro2953 (95% CI 2471, 3436) for haloperidol (p = 0.039), mainly due to a higher ziprasidone acquisition cost. However, costs per responder were lower with ziprasidone (euro5045 [95% CI 4211, 6020]) than with haloperidol (euro5302 [95% CI 3666, 7791], with a cost per additional responder (ICER) for ziprasidone of euro4095 (95% CI -130, 22 231). The acceptability curve showed an ICER cut-off value of euro13 891 at the 95% cost-effectiveness probability level for >or=30% reduction in BPRS negative symptoms. CONCLUSIONS: Compared with haloperidol, ziprasidone was significantly better at controlling psychotic negative symptoms in acute psychoses. The extra cost of ziprasidone was offset by a higher effectiveness rate, yielding a lower cost per responder. In light of the social benefit (less family burden and greater restoration of productivity), the incremental cost per additional responder with sequential IM/oral ziprasidone should be considered cost effective in patients with exacerbation of schizophrenia in Spain.
2007

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

633-645

Issue

9

Volume

27

Citation

Canas F; Perez-Sola V; Diaz S; Rejas J; ZIMO Trial Collaborative Group, “Cost-effectiveness analysis of ziprasidone versus haloperidol in sequential intramuscular/oral treatment of exacerbation of schizophrenia: economic subanalysis of the ZIMO trial.,” Pediatric Palliative Care Library, accessed September 27, 2021, https://pedpalascnetlibrary.omeka.net/items/show/13952.

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