A pharmacoeconomic analysis of sertindole in the treatment of schizophrenia in Sweden

Abstract

Background: Atypical antipsychotics have similar clinical efficacy in the treatment of schizophrenia; variability in their tolerability represents the discerning factor in treatment choices. Sertindole has a relatively good tolerability profile that favours long-term patient adherence and, therefore, is associated with lower rates of relapse and rehospitalization. Aim: A model was developed to compare the cost-effectiveness of a 5-year treatment strategy starting with sertindole versus olanzapine, risperidone, aripiprazole or the typical antipsychotic agent, haloperidol. Methods: The model was based on published trials and local clinical practice, and considered costs from the perspective of the Swedish National Health Insurance Board. Results: All atypical agents were clinically superior and more cost-effective than haloperidol with a cost per quality-adjusted life year gained of approximately 490,000 Swedish kroner. Sertindole was associated with the lowest direct and indirect medical costs, driven by its tolerability profile. Conclusions: Sertindole represents a useful alternative to the current treatment options available in Sweden. Clinical implications: The relatively good tolerability profile of sertindole translates into lower costs of schizophrenia management, primarily driven by substantially lower direct and indirect costs. Sertindole appears to be a clinically and cost-effective alternative in the management of patients with schizophrenia in Sweden.

• Antipsychotics
• Cost-effectiveness
• Cost-utility
• Pharmacoeconomics
• Schizophrenia

Acknowledgements

The authors would like to thank Natalie Barker of Wolters Kluwer Health for medical writing assistance, which was supported by H. Lundbeck A/S.

Disclosure of interest: Eva Lindström is a board member of the “Swedish remission group” founded by Jansen-Cilag and has held lectures and/or received honoraria for Bristol Myers Squibb, Eli Lilly, Astra Zeneca and Jansen-Cilag. EL is principal investigator for the FAST-O study funded by Astra Zeneca. Jonas Eberhard is an associate editor for the Nordic Journal of Psychiatry. Karina Hansen and Christophe Sapin are employees of H. Lundbeck A/S.