Objectives. The aim of this study was to evaluate, in the Polish setting, the cost-effectiveness of aripiprazole once-monthly (Abilify Maintena®) in treating adults with schizophrenia, in the case of the recurrence of psychotic symptoms caused by a persistent and documented lack of compliance during antipsychotic oral therapy, in comparison with long acting injectable formulations of olanzapine and risperidone, which are currently refunded by the health system.
Material and methods. A decision-analytic Markov model was adopted. Both patients' compliance and the subsequent treatment switches were simulated. A10-year time horizon was assumed. The public payer perspective was adopted.
Results. The incremental cost-utility ratio (ICUR) of aripiprazole, given once-monthly, amounted to 70,777 PLN/QALY (quality-adjusted life year) and 57,649 PLN/QALY compared to risperidone and olanzapine LAI, respectively. Both ICURs were below the official threshold in Poland (119,577 PLN/QALY). The sensitivity analysis confirmed the robustness of the results. It included alternative values of discount rates, utility set, third line of treatment, dosage schemes and a different time horizon.
Conclusions. In the Polish setting aripiprazole, given once-monthly, is a cost-effective treatment option as compared with currently reimbursed atypical LAI antipsychotics. The results were robust irrespective of the discount rate and range of utility adopted. The cost effectiveness of aripiprazole given in this form was proven with different approaches taken towards the choice of third line options and time horizon of the treatment.