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Treating schizophrenia with olanzapine long acting injections (LAI) may be more cost effective than oral olanzapine or other LAIs

Andre Tomlin

This year long study carried out by Medical Decision Modeling in Indianapolis set out to measure the cost-effectiveness of the olanzapine long-acting injection with other antipsychotic long-acting injections and oral olanzapine in treating patients with schizophrenia who had trouble adhering to oral drug treatment.

The study used a micro-simulation economic decision model to replicate usual care.  The model used a number of parameters including adherence levels, relapse with and without hospitalisation, treatment discontinuation rates by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct health care costs.

Key outcomes were the direct cost of treatment and the cost effectiveness as measured by quality-adjusted life years (QALYs):

  • The olanzapine long-acting injection was more effective and cheaper than other antipsychotic injections (risperidone, paliperidone and haloperidol)
  • The olanzapine long-acting injection was more effective and most costly than oral olanzapine (estimated incremental cost/QALY of $26,824 compared to oral olanzapine)
  • The olanzapine long-acting injection remained within acceptable cost-effective ranges (<$50,000) in terms of incremental cost/QALY gained.

The authors concluded:

This micro-simulation model finds the olanzapine-LAI treatment strategy to result in better effectiveness and to be a cost-effective alternative compared to oral olanzapine and the LAI formulations of risperidone, paliperidone, and haloperidol in the treatment of non-adherent and partially adherent patients with schizophrenia in the United States. A key limitation is the assumption how LAI therapies compare to oral counterparts due to sparse head-to-head data. Further research is needed to verify baseline assumptions.

Furiak NM, Ascher-Svanum H, Klein RW, Smolen LJ, Lawson AH, Montgomery W, Conley RR. Cost-effectiveness of olanzapine long-acting injection in the treatment of patients with schizophrenia in the United States: a micro-simulation economic decision model. Curr Med Res Opin. 2011 Apr;27(4):713-30. Epub 2011 Jan 25.

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Written by

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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