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首页> 外文期刊>Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research >The cost-effectiveness of atypicals in the UK.
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The cost-effectiveness of atypicals in the UK.

机译：在英国非典型的成本效益。

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BACKGROUND: In 2002, the National Institute for Health and Clinical Excellence (NICE), recommended atypical antipsychotics over conventional ones for first-line schizophrenia treatment, based on their lower risk of extrapyramidal symptoms. OBJECTIVE: To estimate the incremental cost-effectiveness of atypical relative to conventional antipsychotics for the treatment of schizophrenia in the UK. METHODS: A discrete event simulation (DES) model was adopted to reflect the treatment of schizophrenia in the UK. The model estimates symptoms (using the Positive and Negative Symptom Score [PANSS]), psychiatrist visits, pharmacological treatment and treatment location, number and duration of psychotic relapses, level of compliance, quality-adjusted life-years (QALYs), and side effects over a 5-year time period. Probabilistic sensitivity analyses were carried out. Following NICE's "atypical" recommendation, the cost-effectiveness of atypical versus conventional antipsychotics was estimated in a scenario analysis, assuming both groups differ only in side-effect profile. RESULTS: When comparing conventional and atypical antipsychotics, the model predicts that the latter would decrease 5-year costs by 1633 Pound per patient and result in a QALY gain of 0.101. The probabilistic sensitivity analysis suggests these results are robust. The sensitivity analyses indicate that incremental costs and effects are most sensitive to the differential efficacy of atypicals and conventionals, as measured by PANSS. When it is assumed that the only differences between atypicals and conventionals are found in side-effect profiles, the incremental cost-effectiveness ratio of the atypicals is 45,000 Pound per QALY gained. CONCLUSION: According to this DES model for schizophrenia, atypical antipsychotics are cost-effective compared to the conventional antipsychotics. The assumptions used in the model need further validation through large naturalistic based studies with reasonable follow-up to determine the real-life differences between atypicals and conventional antipsychotics.
机译：背景:2002年,国家研究所健康和临床(好),推荐使用非典型抗精神病药物在传统的一线精神分裂症治疗,根据他们的风险降低锥体外系症状。非典型的增量成本效益相对传统的抗精神病药物在英国治疗精神分裂症。采用离散事件仿真(DES)模型反映了精神分裂症的治疗英国。阳性和阴性症状量表(PANSS)),精神病专家互访,药物治疗和治疗位置,数量和持续时间精神病复发,合规,质量调整寿命(提升),一面在5年时间内影响。进行了敏感性分析。漂亮的“非典型”的建议成本效益的非典型和传统抗精神病药物是估计的情景分析,假设两组不同只有在副作用。比较传统和非典型抗精神病药物,模型预测后者将减少5年1633英镑的成本每个病人和导致QALY 0.101。概率敏感性分析显示这些结果是健壮的。分析表明,增量成本和微分效应是最敏感的非典型和传统的功效测量数值。只有非典型和之间的区别传统中发现的副作用,增量成本效益之比非典型是每QALY获得45000英镑。结论:根据这个模型精神分裂症,非典型抗精神病药物成本效益比传统抗精神病药物。需要进一步验证通过自然的基础研究与合理后续确定真实的差异非典型和传统之间抗精神病药物。

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