This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.
Objective: To compare costs and effects of lurasidone with brexpiprazole in adults with schizophrenia.
Methods: A cost-effectiveness model was developed to compare lurasidone with brexpiprazole from a US third-party payer perspective over a 6-month time horizon. In the absence of head-to-head clinical data, an adjusted treatment comparison of lurasidone versus brexpiprazole, using placebo data as the common comparator, was conducted to measure effectiveness (i.e., response rate defined as patients achieving ≥20% improvement in Positive and Negative Symptom Scale at week 6). The effectiveness data were drawn from 4 lurasidone and 2 brexpiprazole published clinical trials. Data for direct healthcare costs of response and non-response were obtained from an observational study of patients treated for schizophrenia. Drug costs were derived from PriceRx. Model robustness was tested using univariate/probabilistic sensitivity analyses.
Results: At week 6, response rates for lurasidone and brexpiprazole were 57.0% and 50.5%, respectively. Over the 6-month period, lurasidone patients had lower total healthcare ($20,156 vs. $20,986), outpatient ($9,629 vs. $10,206), inpatient ($5,596 vs. $5,609), and emergency department ($303 vs. $310) costs than brexpiprazole patients, respectively. A cost saving of $12,738 per additional response was achieved with lurasidone versus brexpiprazole. The univariate sensitivity analysis revealed that the model was most sensitive to lurasidone and brexpiprazole response rates. The probabilistic sensitivity analysis showed that, at a willingness-to-pay threshold of $10,000/response, lurasidone had a 65.4% probability of being cost-effective compared to brexpiprazole.
Conclusion: Lurasidone may be a cost-effective option when compared with brexpiprazole for the acute treatment of adults with schizophrenia.