ECONOMIC EVALUATION OF PALIPERIDONE PALMITATE FOR TREATING CHRONIC SCHIZOPHRENIA PATIENTS IN THE UAE

OBJECTIVES: Schizophrenia is a long-term mental disorder that affects how a person thinks feels and behaves. Management of these patients is both clinically and financially challenging. In the United Arab Emirates (UAE), standard of care (SoC) is daily oral antipsychotics which have adherence concerns. Paliperidone palmitate (PP-LAI) has recently been approved for chronic schizophrenia and is administered monthly. This is an economic evaluation of PP-LAI in the UAE. METHODS: A cost-utility analysis was conducted using a previously validated 1 year decision tree model reflecting the treatment pathways, costs and outcomes of three treatment options; PP-LAI monotherapy, SoC or PP-LAI plus SoC. Direct costs, inflated to 2016 where applicable, and treatment effects were obtained from literature and standard price lists. Where these were not available, data were collected from a local panel of experts who also validated the treatment pathways. The primary outcome was the cost per quality-adjusted life-year (QALY) gained RESULTS: The average PP-LAI patient in the base case with or without SoC experienced 0.840 QALYs while the SoC patient experienced 0.812 QALY. Since the PP-LAI plus SoC group cost more than the PP-LAI monotherapy without additional QALY gains, PP-LAI plus SoC was discarded from further analysis. PP-LAI monotherapy resulted in incremental cost savings of AED 831 (USD 226) when compared to SoC. PP-LAI monotherapy is therefore projected to be an economically dominant treatment option. Dominance drivers were greater remission days and lower hospitalization and ER visits for PP-LAI vs SoC. The model was sensitive to a wide range of published SoC adherence rates. In scenario analyses, the conclusions were between increased economic dominance and highly cost-effective when PP-LAI monotherapy was compared to SoC. CONCLUSIONS: PP-LAI is projected to save costs and improve patient outcomes in the UAE and should be considered a viable treatment alternative by payers and prescribers alike.