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Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics

  • Robert A. Rosenheck (a1)

Abstract

Background

Second-generation antipsychotics may have few advantages over older, cheaper drugs, except for possibly reduced risk of tardive dyskinesia.

Aims

To evaluate the cost-effectiveness of second-generation antipsychotics with regard to reducing tardive dyskinesia.

Method

Literature was reviewed on risk of tardive dyskinesia with second-generation antipsychotics; on severity duration and impairment of tardive dyskinesia; and on the relationship of this disorder to quality of life and quality-adjusted life-years (QALYs). Diverse cost and benefit assumptions and of 1-year and 5-year planning horizons were examined in a deterministic sensitivity analysis.

Results

Estimating 0.143 QALYs lost per case of severe tardive dyskinesia, 1-year cost-effectiveness estimates for second-generation antipsychotics ranged from $185 000 ($370 000) to $850 000 ($1.7 million) per QALY, and 5-year cumulative estimates ranged from $74 000 ($ 149 000) to $342 000 ($683 000) per QALY, all above the conventional policy threshold of $25 000 ($50 000).

Conclusions

Reduction of tardive dyskinesia with second-generation antipsychotics appears unlikely to meet standards for cost-effectiveness.

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Copyright

Corresponding author

Dr R. Rosenheck, Northeast Program Evaluation Center (182), VA Connecticut Health Care System, 950 Campbell Avenue, West Haven, CT 06516, USA. Tel: +1 203 937 3850; fax: + 1 203 937 3433; e-mail: Robert.Rosenheck@Yale.Edu

Footnotes

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Declaration of interest

R.A.R. has received research support from and/or been a consultant to Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmith Kline, Janssen Pharmaceutica and Wyeth.

Footnotes

References

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Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics

  • Robert A. Rosenheck (a1)
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