Quality of life and drug costs associated with switching antipsychotic medication to once-daily extended release quetiapine fumarate in patients with schizophrenia

ABSTRACT

Objective: The objective of this study was to assess the quality of life and drug costs associated with switching from any ongoing antipsychotic treatment to once-daily extended release quetiapine fumarate (quetiapine XR) in patients with schizophrenia.

Methods: This assessment was based on data collected during a 12-week study in patients with schizophrenia (n = 477) who switched from their current antipsychotic due to insufficient efficacy or poor tolerability to a flexible dose of quetiapine XR. Patients were assigned utilities based on their Positive and Negative Syndrome Scale (PANSS) scores and the presence of adverse events by applying the methods of Lenert et al.. Quality adjusted life year (QALY) gains were calculated assuming a linear change of utility between two consecutive visits. Incremental costs were calculated by comparing the hypothetical mean drug cost (assuming patients stay on previous treatment) with the actual mean cost of quetiapine XR based on European prices.

Results: Patients who completed the study (n = 279) increased their average utility by 0.116, corresponding to a QALY gain of 0.0207. For the total sample, the mean utility increased by 0.09, reflecting a QALY gain of 0.0170. The additional costs for quetiapine XR per QALY gained varied from approximately €16,000 to €24,000. Notably, this is a non-comparative study; therefore, no conclusions can be reached regarding the relative impact of switching to quetiapine XR compared with other antipsychotics. Further limitations included the short trial duration on which the utility estimates are based, and the restriction of cost data to drug costs alone. Furthermore, in a ‘real world’ scenario, it is to be expected that other drug regimens might be introduced during periods of treatment failure.

Conclusion: This analysis demonstrates that patients with schizophrenia who switch their antipsychotic medication to quetiapine XR because of insufficient efficacy or poor tolerability benefit from significant QALY gains at a reasonable increase in drug cost.

Key words: :

• Antipsychotics
• Costs
• Quality of life
• Quetiapine XR
• Schizophrenia
• Switch

Acknowledgements

Declaration of interest: This study was supported by AstraZeneca Pharmaceuticals. K.J. and J.L. are employees of AstraZeneca. N.K. and A.B. are employees of United BioSource Corporation, and have received consulting fees from AstraZeneca.

The authors thank K. Ian Johnson from the Evidence Research Unit, Complete Medical Group, who provided medical writing support, funded by AstraZeneca. The authors also thank the journal reviewers for their comments.