THE COST AND EFFECTS OF ATYPICAL ANTIPSYCHOTIC AGENTS IN PATIENTS WITH SCHIZOPHRENIA IN SLOVENIA: A COST EFFECTIVENESS STUDY

Background: Treatment with atypical antipsychotics is the most important treatment for patients with acute schizophrenia and represents a significant cost. In Slovenia there is lack of studies of cost-effectiveness that can be used in clinical practice. Objective: The primary purpose of the study was to compare the costs and effectiveness of five atypical antipsychotic with the largest market share in 2011 in Slovenia. The study included aripiprazole, quetiapine, paliperidone, risperidone and olanzapine. Methods: The target population of the study were patients with acute schizophrenia in Slovenia. Each of the five antipsychotic drugs represents a major branch of the decision tree. Therapeutic effectiveness was defined as the percentage of patients in remission. The cost of daily treatment with each drug was obtained from the data traffic and market share in 2011, the costs of mental health care in Slovenia from the Health Insurance Institute of Slovenia. The study was conducted from the payer's perspective, the Health Insurance Institute of Slovenia. Results: Treatment with risperidone is the cheapest, while the most efficient is olanzapine. The strategy of treatment with risperidone has the smallest ration of cost-effectiveness. The strategy of treatment with aripiprazole, paliperidone and quetiapine are dominated. The price of treatment per year: (sic)6812 for risperidone, (sic)7509 for quetiapine, (sic)7295 for olanzapine, (sic)8229 for aripiprazole and (sic)8044 for paliperidone. The efficiency given as a percentage of patients in remission are: 0.605 for quetiapine, 0.603 for aripiprazole, 0.671 for risperidone, 0.723 for olanzapine and 0.712 for paliperidone. Conclusion: The data shows that the most cost-effective treatment of acute schizophrenia is with risperidone and olanzapine.