Quality-adjusted life year difference in patients with predominant negative symptoms of schizophrenia treated with cariprazine and risperidone
Abstract
Aim: Our study aimed at estimating differences in quality-adjusted life year (QALY) gain for patients with predominant negative symptoms of schizophrenia treated with cariprazine compared with risperidone. Materials & methods: A Markov model was built, based on the Mohr–Lenert approach and data derived from clinical trials, to estimate potential QALY gains of patients. Results: Patients had higher probability of reaching better health states treated with cariprazine compared with risperidone. In the model, this resulted in an estimated QALY gain of 0.029 per patient, after 1 year of treatment. Conclusion: Cariprazine, which showed clinically meaningful improvement in the symptoms, and personal and social performance, can also provide significant QALY gain in the treatment of patients with predominant negative symptoms of schizophrenia compared with risperidone.
Supplementary Material
File (suppl_appendix.docx)
- Download
- 35.39 KB
References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
World Health Organization. Schizophrenia Fact sheet (2016). www.who.int/mediacentre/factsheets/fs397/en/
2.
Desai PR, Lawson KA, Barner JC, Rascati KL. Estimating the direct and indirect costs for community-dwelling patients with schizophrenia. J. Pharm. Health Serv. Res. 4(4), 187–194 (2013).
3.
Cloutier M, Aigbogun MS, Guerin A et al. The economic burden of schizophrenia in the United States in 2013. J. Clin. Psychiatry 77(6), 764–771 (2016).
4.
Tandon R, Nasrallah HA, Keshavan MS. Schizophrenia, “just the facts” 4. Clinical features and conceptualization. Schizophr. Res. 110(1–3), 1–23 (2009).
5.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th Edition). American Psychiatric Publishing, VA, USA (2013).
6.
Chue P, Lalonde JK. Addressing the unmet needs of patients with persistent negative symptoms of schizophrenia: emerging pharmacological treatment options. Neuropsychiatr. Dis. Treat. 10, 777–789 (2014).
7.
Debelle M, Németh G, Szalai E et al. Cariprazine as monotherapy for the treatment of schizophrenia patients with predominant negative symptoms: a double-blind, active controlled trial. Eur. Neuropsychopharmacol. 25, S510 (2015).
8.
Németh G, Laszlovszky I, Czobor P et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet 389(10074), 1103–1113 (2017).
•• Summarizes the results of the clinical trial that served as the basis of the calculations of the model.
9.
Németh G, Debelle M, Laszlovszky I et al. Monotherapy treatment with cariprazine for the treatment of predominant negative symptoms of patients with schizophrenia: a double-blind, active comparator-controlled trial. Eur. Psychiatry 33, S256–S257 (2016).
10.
Citrome L. Cariprazine: chemistry, pharmacodynamics, pharmacokinetics, and metabolism, clinical efficacy, safety, and tolerability. Expert Opin. Drug Metabol. Toxicol. 9(2), 193–206 (2013).
11.
Nakamura T, Kubota T, Iwakaji A, Imada M, Kapas M, Morio Y. Clinical pharmacology study of cariprazine (MP-214) in patients with schizophrenia (12-week treatment). Drug Design Dev. Ther. 10, 327–338 (2016).
12.
Pásztor Mészáros G, Kapás M, Borsos M et al. Pharmacokinetics of RGH-188, a new dopamine D3/D2 antagonist/partial agonist atypical antipsychotic, in healthy subjects. Eur. Neuropsychopharmacol. 17, S451–S452 (2007).
13.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr. Bull. 13(2), 261–276 (1987).
14.
Mohr PE, Cheng CM, Claxton K et al. The heterogeneity of schizophrenia in disease states. Schizophr. Res. 71(1), 83–95 (2004).
•• One of the three publications that explain the foundations of the Mohr–Lenert method, which was the basis of the Markov model structure.
15.
Lenert LA, Sturley AP, Rapaport MH, Chavez S, Mohr PE, Rupnow M. Public preferences for health states with schizophrenia and a mapping function to estimate utilities from positive and negative symptom scale scores. Schizophr. Res. 71(1), 155–165 (2004).
•• One of the three publications that explain the foundations of the Mohr–Lenert method, which was the basis of the Markov model structure.
16.
Lenert LA, Rupnow MF, Elnitsky C. Application of a disease-specific mapping function to estimate utility gains with effective treatment of schizophrenia. Health Qual. Life Outcomes 3(1), 57 (2005).
•• One of the three publications that explain the foundations of the Mohr–Lenert method, which was the basis of the Markov model structure.
17.
Lenert LA, Sturley AP, Rapaport MH, Chavez S, Mohr PE, Rupnow M. Corrigendum to Public preferences for health states with schizophrenia and a mapping function to estimate utilities from positive and negative symptom scale scores [Schizophr. Res. 71(1) (2004) 155–165]. Schizophr. Res. 80, 135–136 (2005).
18.
Elfadaly FG, Garthwaite PH. Eliciting Dirichlet and Gaussian copula prior distributions for multinomial models. Stat. Computing 27(2), 449–467 (2017).
19.
Glick ID, He X, Davis JM. First-generation antipsychotics: current status. Primary Psychiatry 13(12), 51–58 (2006).
20.
Furiak NM, Ascher-Svanum H, Klein RW et al. Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States. Cost Eff. Resour. Alloc. 7, 4 (2009).
21.
García-Ruiz AJ, Pérez-Costillas L, Montesinos AC, Alcalde J, Oyagüez I, Casado MA. Cost-effectiveness analysis of antipsychotics in reducing schizophrenia relapses. Health Econ. Rev. 2, 8 (2012).
22.
Park T, Kuntz KM. Cost-effectiveness of second-generation antipsychotics for the treatment of schizophrenia. Value Health 17(4), 310–319 (2014).
23.
Lieberman JA, Stroup TS, Mcevoy JP et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N. Engl. J. Med. 353(12), 1209–1223 (2005).
• Basis of the calculations regarding switching rates.
24.
Severens JL, Milne RJ. Discounting health outcomes in economic evaluation: the ongoing debate. Value Health 7(4), 397–401 (2004).
25.
Hungarian Central Statistical Office. Demographic Yearbook 2012. Hungarian Central Statistical Office, Budapest, Hungary (2013).
26.
National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal 2013 (2013). www.nice.org.uk/process/pmg9/chapter/foreword
Information & Authors
Information
Published In
Copyright
© Future Medicine Ltd.
History
Published online: 17 May 2017
Keywords:
Topics
Authors
Metrics & Citations
Metrics
Article Usage
Article usage data only available from February 2023. Historical article usage data, showing the number of article downloads, is available upon request.
Citations
How to Cite
Quality-adjusted life year difference in patients with predominant negative symptoms of schizophrenia treated with cariprazine and risperidone. (2017) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2017-0024
Export citation
Select the citation format you wish to export for this article or chapter.
Citing Literature
- Shivam Tyagi, Ajeet Sidana, Sushmita Bhattacharya, Antipsychotics and their Impact on Biopsychosocial Outcomes in Schizophrenia: A Randomized Comparative Study, Indian Journal of Social Psychiatry, 10.4103/ijsp.ijsp_371_25, 42, 1, (33-40), (2026).
- František Petrovič, František Murgaš, Anna Tirpáková, Marie Hubálovská, György Molnár, Roman Králik, Ján Zozuľak, Enikő Nagy, Marek Nocoń, Zoltán Balogh, Measuring the quality of life university students and its predictors as a basis for its applied research. Cross-country evidence, Sustainable Futures, 10.1016/j.sftr.2025.101214, 10, (101214), (2025).
- Keyuri Adhikari, Khalid Kamal, Ki Jin Jeun, David Nolfi, Mohammed Ashraf, Christopher Zacker, Real-World Effectiveness, Economic, and Humanistic Outcomes of Selected Oral Antipsychotics in Patients with Schizophrenia: A Systematic Review Evaluating Global Evidence, ClinicoEconomics and Outcomes Research, 10.2147/CEOR.S469024, Volume 16, (621-645), (2024).
- S.G. Sukiasyan, ANTIPSYCHOTIC DRUGS: THREE GENERATIONS OF ANTIPSYCHOTICS, ARMENIAN JOURNAL OF MENTAL HEALTH, 10.55436/10.54436/1829202X-15.2024.1-3, (3-26), (2024).
- Andrea de Bartolomeis, Mariateresa Ciccarelli, Giuseppe De Simone, Benedetta Mazza, Annarita Barone, Licia Vellucci, Canonical and Non-Canonical Antipsychotics’ Dopamine-Related Mechanisms of Present and Next Generation Molecules: A Systematic Review on Translational Highlights for Treatment Response and Treatment-Resistant Schizophrenia, International Journal of Molecular Sciences, 10.3390/ijms24065945, 24, 6, (5945), (2023).
- David Taylor, Ramalingam Chithiramohan, Jasdev Grewal, Avirup Gupta, Lars Hansen, Gavin P. Reynolds, Sofia Pappa, Dopamine partial agonists: a discrete class of antipsychotics, International Journal of Psychiatry in Clinical Practice, 10.1080/13651501.2022.2151473, 27, 3, (272-284), (2022).
- Sofia Pappa, Arturas Kalniunas, Hitendra Sharma, Ali Raza-Syed, Manzar Kamal, Fintan Larkin, Efficacy and safety of cariprazine augmentation in patients treated with clozapine: a pilot study, Therapeutic Advances in Psychopharmacology, 10.1177/20451253221132087, 12, (2022).
- Richard Dodel, Christopher Kruse, Annette Conrads-Frank, Uwe Siebert, Pharmacoeconomics, NeuroPsychopharmacotherapy, 10.1007/978-3-030-62059-2_381, (101-234), (2022).
- David Bruhn, Steve Hwang, Ana Howarth, Sanjay Dubé, The burden of illness for patients with schizophrenia and primary negative symptoms: A systematic literature review, Schizophrenia Research, 10.1016/j.schres.2022.09.017, 248, (341-344), (2022).
- Michael Davidson, Jay Saoud, Corinne Staner, Nadine Noel, Sandra Werner, Elisabeth Luthringer, David Walling, Mark Weiser, Philip D Harvey, Gregory P Strauss, Remy Luthringer, Efficacy and Safety of Roluperidone for the Treatment of Negative Symptoms of Schizophrenia, Schizophrenia Bulletin, 10.1093/schbul/sbac013, 48, 3, (609-619), (2022).