Lurasidone in Adults with Schizophrenia in the UK: A Cost Consequence Analysis Considering Cost Implications of Improved Efficacy and Safety.

Lurasidone is an atypical antipsychotic with a favourable metabolic adverse event profile, indicated for treatment of adults with schizophrenia. The objective of this study was to perform an analysis of the impact of lurasidone on the National Health Service budget in the UK. A 3-year budget impact model was developed based on epidemiological estimates of total number of adults beginning antipsychotic therapy for schizophrenia. Costs considered included drug acquisition, weight gain, diabetes, and hospitalisations associated with relapse. Lurasidone 3-year uptake was based on projected displacement of the following atypical antipsychotics: olanzapine, risperidone, quetiapine and aripiprazole. Efficacy data were based on indirect comparisons. Univariate sensitivity analysis was conducted to assess the impact of differential rates of displacement. The current annual cost of schizophrenia in the population beginning antipsychotic therapy was approximately £17m. In year 1, treatment costs represented 7% of total costs; hospitalisations, weight gain and diabetes represented 90%, 3% and 1%, respectively. Base case uptake of lurasidone was assumed to be 5.5% annually. Assuming that lurasidone displaced only aripiprazole, lurasidone was associated with a net cumulative saving of £1.9m by year 3. Assuming lurasidone took market share equally from all considered atypicals, the net cumulative saving was £739k by year 3. In this equal displacement scenario, lurasidone uptake ranging from 2.5% to 11% resulted in estimated cumulative 3-year savings of £369k to £1.5m, respectively. Lurasidone was associated with cost savings in all scenarios. Estimates of annual budget impact ranged from cost savings of £369k to £1.9m. Cost savings were driven predominantly by reduced rates of hospitalisations associated with relapse, but also reduced costs of weight gain and diabetes.