Cost-effectiveness of asenapine in the treatment of bipolar disorder in Canada

Jan 24, 2014BMC psychiatry

Cost-effectiveness of asenapine for treating bipolar disorder in Canada

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Abstract

Asenapine is associated with lower costs and more quality-adjusted life years (QALYs) compared to olanzapine in treating bipolar disorder.

Asenapine is a dominant treatment option over olanzapine from both a Canadian Ministry of Health and societal perspective.
The economic evaluation included the assessment of extrapyramidal symptoms, weight gain, and long-term metabolic complications.
Probabilistic sensitivity analysis showed that asenapine continues to be a dominant strategy in 99.2% of scenarios.
The findings suggest that asenapine may provide a more favorable economic impact in the treatment of bipolar disorder.

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BACKGROUND: Bipolar disorder (BPD) is prevalent and is associated with a significant economic burden. Asenapine, the first tetracyclic antipsychotic approved in Canada for the treatment of BPD, has shown a comparable efficacy profile to other atypical antipsychotics. In addition, it is associated with a favourable metabolic profile and minimal weight gain potential. This study aimed to assess the economic impact of asenapine compared to olanzapine in the treatment of BPD in Canada.

METHODS: A decision tree combined with a Markov model was constructed to assess the cost-utility of asenapine compared with olanzapine. The decision tree takes into account the occurrence of extrapyramidal symptoms (EPS), the probability of switching to a different antipsychotic, and the probability of gaining weight. The Markov model takes into account long-term metabolic complications including diabetes, hypertension, coronary heart diseases (CHDs), and stroke. Analyses were conducted from both a Canadian Ministry of Health (MoH) and a societal perspective over a five-year time horizon with yearly cycles.

RESULTS: In the treatment of BPD, asenapine is a dominant strategy over olanzapine from both a MoH and a societal perspective. In fact, asenapine is associated with lower costs and more quality-adjusted life years (QALYs). Results of the probabilistic sensitivity analysis indicated that asenapine remains a dominant strategy in 99.2% of the simulations, in both a MoH and a societal perspective, and this result is robust to the many deterministic sensitivity analyses performed.

CONCLUSIONS: This economic evaluation demonstrates that asenapine is a cost-effective strategy compared to olanzapine in the treatment of BPD in Canada.

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Cost-effectiveness of asenapine in the treatment of bipolar disorder in Canada

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