Cost-utility of aripiprazole once-monthly versus paliperidone palmitate once-monthly injectable for schizophrenia in China

Objectives From the perspective of Chinese healthcare system, this study compared the cost-utility of aripiprazole once-monthly (AOM) and paliperidone palmitate once-monthly injectable for the treatment of adult Chinese patients with schizophrenia. Methods A 5-state Markov model was constructed to assess the cost-utility of 10 years of treatment with long-acting injections (LAI) for schizophrenia. The long-term costs and quality-adjusted life years (QALYs) were estimated. The outcome was the incremental cost-effectiveness ratio (ICER). The annual discount rate was set at 5 %. Willingness-to-pay (WTP) threshold of 1x GDP was used to judge the economics of intervention. Results In the base-case, the incremental costs of AOM relative to PP1M after 10 years of treatment were US$1,926.373 with an incremental QALYs of 0.306. The ICER for AOM was US$6,285.303/QALY, which was lower than the WTP threshold of US$12,538.306/QALY. The one-way sensitivity analysis and probability sensitivity analysis verified the robustness of the base-case. Scenario analysis showed that from 10 to 30 years, as the horizon increased, the ICER became smaller, and all were below the WTP. Conclusions This analysis showed that compared with PP1M, AOM represents a long-term cost-utility advantages for schizophrenia treatment in China.