Cost-effectiveness analysis of aripiprazole vs standard-of-care in the management of community-treated patients with schizophrenia: STAR study

D. King, M. Knapp, P. Thomas, D. Razzouk, J. Y. Loze, Hongjun Kan, M. Van Baardewijk

Research output: Contribution to journalArticle

Abstract

Background: The Schizophrenia Trial of Aripiprazole (STAR) showed superior efficacy for aripiprazole compared with atypical antipsychotic standard-of-care (SOC) for the community treatment of schizophrenia1 based on the Investigator Assessment Questionnaire total score. Objective: To determine the cost-effectiveness of aripiprazole compared with SOC medications from a health and social care system perspective. Methods: Information on health and social care service use was collected using the Client Socio-demographic and Service Receipt Inventory (CSSRI). Unit costs attached to each service were used to calculate patients' healthcare and other costs. The primary outcome measure was Investigator's Assessment Questionnaire (IAQ) score; secondary measures included the Clinical Global Impression (CGI)-Improvement response and Quality of Life Scale (QLS). Incremental cost-effectiveness was measured over 26 weeks as the ratio of the difference in mean costs between aripiprazole and SOC (olanzapine, quetiapine and risperidone) to the difference in mean outcomes. Net benefit was used to plot the cost-effectiveness acceptability curve. Results: The analysis sample (all randomised subjects who met the study inclusion criteria) included 282 individuals randomised to aripiprazole and 266 to SOC (olanzapine, n75; quetiapine, n110 and risperidone, n81). The additional mean cost of achieving a clinically significant difference on the IAQ was £3896, where a clinically significant difference was taken to be an 8-point improvement. The cost-effectiveness acceptability curve for the IAQ indicated that aripiprazole has a relatively high probability of being viewed as cost-effective for a range of plausible values attached to the incremental outcome difference. Additional costs of a clinically significant improvement on the CGI-Improvement and QLS were £575 and £835, respectively. These measures therefore support the view that aripiprazole is more cost-effective than SOC from a health and social care perspective for people with schizophrenia treated in the community. Conclusion: In the STAR study, use of aripiprazole in the management of patients with schizophrenia was cost-effective.

Original languageEnglish (US)
Pages (from-to)365-374
Number of pages10
JournalCurrent Medical Research and Opinion
Volume27
Issue number2
DOIs
StatePublished - Feb 2011
Externally publishedYes

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Standard of Care
Cost-Benefit Analysis
Schizophrenia
Costs and Cost Analysis
olanzapine
Research Personnel
Risperidone
Delivery of Health Care
Quality of Life
Aripiprazole
Social Work
Health Care Costs
Antipsychotic Agents
Demography
Outcome Assessment (Health Care)
Equipment and Supplies
Surveys and Questionnaires

Keywords

  • Aripiprazole
  • Atypical antipsychotic
  • Cost-effectiveness
  • Schizophrenia
  • STAR study

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cost-effectiveness analysis of aripiprazole vs standard-of-care in the management of community-treated patients with schizophrenia : STAR study. / King, D.; Knapp, M.; Thomas, P.; Razzouk, D.; Loze, J. Y.; Kan, Hongjun; Van Baardewijk, M.

In: Current Medical Research and Opinion, Vol. 27, No. 2, 02.2011, p. 365-374.

Research output: Contribution to journalArticle

King, D. ; Knapp, M. ; Thomas, P. ; Razzouk, D. ; Loze, J. Y. ; Kan, Hongjun ; Van Baardewijk, M. / Cost-effectiveness analysis of aripiprazole vs standard-of-care in the management of community-treated patients with schizophrenia : STAR study. In: Current Medical Research and Opinion. 2011 ; Vol. 27, No. 2. pp. 365-374.
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