Comparative cost-effectiveness of amisulpride and olanzapine in the treatment of schizophrenia in China

ABSTRACT

Background

Both amisulpride and olanzapine are leading treatments for schizophrenia in China. This study aimed to investigate the long-term cost-effectiveness of amisulpride and olanzapine in the treatment of schizophrenia in China.

Methods

A decision-analytic Markov model was developed to simulate the lifetime clinical and economic outcomes of schizophrenia treatment from the healthcare payer perspective. The long-term costs and QALYs were estimated. Sensitivity analyses were performed to explore the impact of variance of parameters on the results.

Results

Treatment with amisulpride provided an effectiveness gain of 16.59 QALYs at an average cost of USD 25,884 whereas olanzapine resulted in 16.38 QALYs at a cost of USD 34,839 over a lifetime horizon. One-way sensitivity analysis suggested that the most sensitive variable was the unit cost of olanzapine. In a probabilistic sensitivity analysis based on a Monte Carlo simulation with a lifetime horizon, the probability of amisulpride being cost-effective was 99.8% at a willingness-to-pay threshold of USD 9,322, the GDP per capita in China 2018. A scenario analysis with updated olanzapine unit cost suggested an ICER of 7,857 USD/QALY.

Conclusions

Amisulpride is likely to be a cost-effective option with increased effectiveness compared with olanzapine in the treatment of schizophrenia patients in China.

KEYWORDS:

• Schizophrenia
• antipsychotics
• cost-effectiveness analysis
• quality-adjusted life-years

Article highlights

• Schizophrenia is one of the most severe and costly metal illnesses worldwide.

• Long-term cost-effectiveness analysis of the two effective atypical antipsychotic drugs amisulpride and olanzapine were unavailable.

• A decision-analytic Markov model was developed to stimulate the lifetime clinical and economic outcomes of amisulpride and olanzapine.

• Amisulpride is likely to be a cost-effective option with increased effectiveness compared with olanzapine.

Acknowledgments

The authors sincerely thank Dr. Kaida Jiang from Shanghai Mental Health Center, Dr. Fujun Jia from Guangdong General Hospital, Dr. Xiaoping Wang from Xiangya Second Hospital, Dr. Qiang Li from Xi’an Jiaotong University Affiliated First Hospital, Dr. Hong Deng from Hua Xi Hospital of Sichuan University, and Dr. Li Yi from Wuhan Mental Health Center for their expert opinions on relevant local cost data inputs in the analysis. The authors also want to thank Ms. Xueying Shang from Yale University for her support of literature review, and Dr. Xie Yang and Ms. Jenny Liu for their help in proofreading and polishing this manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

S Qu is an employee of IQVIA China and received research funds from Sanofi China. C Li is an employee of Sanofi China. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was funded by by Sanofi China.