Budget Impact of Aripiprazole Once Every Two Months Long-Acting Injectable for Adult Patients with Schizophrenia in the US

This study was sponsored by Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA, and H. Lundbeck LLC, Deerfield, IL, USA. Aripiprazole, an antipsychotic with an established efficacy and safety profile, is available for managing schizophrenia as a ready-to-use injectable formulation (Ari2MRTU), for administration once every 2 months. Ari2MRTU provides plasma concentrations similar to the aripiprazole once every month injectable formulation. A model was developed to estimate the budget impact of introducing Ari2MRTU in a hypothetical US health plan of one million members, including 11,000 (1.1%) patients with schizophrenia, 60% of whom were eligible for maintenance antipsychotic treatment. Inputs to the model included estimates of current and projected market share of comparator drugs, forecast uptake of Ari2MRTU, treatment acquisition, administration, and initiation costs, hospitalization (due to relapse) costs, time on treatment, and treatment compliance. The difference in total annual costs between the scenarios with and without Ari2MRTU was used to calculate the net budget impact of its introduction over a 3-year time horizon. Other outputs included cost per health plan member per month (PMPM) and per treated health plan member per month (PTMPM). The total budget impact of introducing Ari2MRTU was estimated to result in an overall saving of $26,998 at 3 years, a PMPM saving of $0.001 and a PTMPM saving of $0.11. A sensitivity analysis indicated that the savings were sensitive to treatment compliance and the acquisition cost of Ari2MRTU. We concluded that the introduction of Ari2MRTU as a maintenance treatment for adults with schizophrenia is expected to be cost neutral with respect to US payer budgets, and a potentially favorable option for patients who prefer less frequent dosing.