Cost-effectiveness analysis of olanzapine and risperidone in schizophrenic patients in the Indian healthcare settings of Andhra Pradesh, India

Abstract

Abstract Objectives The prevalence of schizophrenia in Andhra Pradesh, India is 279, and the crude disability-adjusted life year is 177 per 100 thousand people. It is one of the major mental health problems of the state. However, there is a dearth of information regarding the pharmacoeconomics of schizophrenia treatment. The purpose of this study was to evaluate the cost and effectiveness of the two most commonly used drugs olanzapine and risperidone for schizophrenia. Methods A prospective observational study was carried out in a tertiary care teaching hospital (Department of psychiatry) for a period of 1 year among 124 schizophrenia patients. The data were collected in a specially designed patient data form, and the cost and effectiveness of the treatment were evaluated. Then, the ICER for olanzapine 71 and risperidone 53 users were calculated. Sensitivity analysis was run creating a model to identify uncertainties and its effect on the results. Key findings The mean cost per patient for olanzapine was 89.96 USD, and risperidone was 85.56 USD for 8 weeks from the start of the treatment. The incremental effects and value of the treatment score with the Positive and Negative Syndrome Scale (PANSS) for olanzapine (27.33) were greater than that of risperidone (20.38). The cost (USD) per PANSS reduction for olanzapine was 3.29 and risperidone was 4.20. The overall incremental cost-effectiveness ratio (ICER) of olanzapine compared to risperidone was 0.63 USD/PANSS. Conclusion The results showed that olanzapine was a cost-effective drug and an alternative to risperidone in the Indian healthcare settings. With further revision and validation, the cost-effectiveness outcome of olanzapine and risperidone can be used to inform any comprehensive healthcare financing mechanism in Indian healthcare settings.