Cost-effectiveness of quetiapine with lithium or divalproex for maintenance treatment of bipolar I disorder
| Autor: | Arthur Lazarus, Tatia Chay Woodward, Jennifer Kim, Eskinder Tafesse, Peter Quon |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Divalproex Dibenzothiazepines Pediatrics medicine.medical_specialty Bipolar Disorder Bipolar I disorder Adolescent Cost effectiveness Cost-Benefit Analysis Population Severity of Illness Index law.invention Quetiapine Fumarate Young Adult Randomized controlled trial law Humans Medicine education Psychiatry Aged education.field_of_study business.industry Valproic Acid Health Policy Middle Aged medicine.disease Markov Chains Lithium Compounds Quetiapine Anticonvulsants Drug Therapy Combination Female medicine.symptom business Mania Antipsychotic Agents medicine.drug |
| Zdroj: | Journal of Medical Economics. 12:259-268 |
| ISSN: | 1941-837X 1369-6998 |
| Popis: | Bipolar I disorder is a recurrent illness that affects 1% of the US population and constitutes a large economic burden. Few studies have investigated the cost-effectiveness of maintenance treatment options. The objective of this analysis was to assess the cost-effectiveness of quetiapine (QTP) in combination with lithium (Li) or divalproex (DVP) compared with that of Li or DVP alone for maintenance treatment of bipolar disorder.The cost-effectiveness of maintenance treatment with QTP in combination with Li or DVP was compared with placebo (PBO) in combination with Li or DVP from a US direct costs perspective using a Markov model. The model simulated a cohort of 1,000 stabilized patients with bipolar I disorder and estimated the quarterly risk in three health states: euthymia, mania, and depression. Efficacy data were derived from two randomized, double-blind, placebo-controlled trials comparing QTP + Li/DVP with PBO + Li/DVP for up to 2 years. Resource data were obtained from published literature. Direct costs included drug costs, hospitalizations, and physician visits. Outcomes and costs were discounted at 3% and the price reference year was 2007. Endpoints included the number of acute mood episodes, hospitalizations due to an acute mood event, and costs per quality-adjusted life-years. A probabilistic sensitivity analysis (PSA) was conducted to evaluate uncertainty.In the base-case analysis, QTP + Li/DVP dominated PBO + Li/DVP. The PSA showed these results to be robust. In addition, treatment with QTP + Li/DVP was associated with reductions in acute manic episodes (46%), acute depressive episodes (41%), and related hospitalizations (44%) compared with PBO + Li/DVP.These analyses, based on two randomized clinical trials, suggest that QTP + Li/DVP is a cost-effective maintenance treatment option for patients with bipolar I disorder compared with Li or DVP alone. |
| Databáze: | OpenAIRE |
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