Cost-Effectiveness of Sertindole among Atypical Antipsychotics in the Treatment of Schizophrenia in South Korea

ObjectivesThis study assessed the cost-effectiveness of sertindole compared with existing atypical antipsychotics in the treatment of patients with schizophrenia in the South Korean setting.MethodsA Markov model was developed to estimate the cost-effectiveness of sertindole compared with risperidone, olanzapine, and quetiapine with a cycle of 6 months on a 5-year time horizon. Effectiveness was defined as the length of time without relapse and quality-adjusted life-years. Parameter estimates including drug-induced adverse events, compliance rate, and relapse rate were based on published literature and clinical trial data. Resource utilization data were obtained from the 2010 National Health Insurance reimbursement data, and costs were estimated from the health care system's perspective. A discount rate of 5% was applied to both cost and effectiveness. One-way sensitivity analyses and probabilistic sensitivity analysis were carried out to check the robustness of the base-case analysis.ResultsThe length of time without relapse was 1.90 years for all study drugs. The estimated quality-adjusted life-years were 1.27 for sertindole, followed by quetiapine, risperidone, and olanzapine. Total costs were 10.51 million Korean won (KRW) for sertindole, 12.86 million KRW for olanzapine, 8.38 million KRW for risperidone, and 8.91 million KRW for quetiapine. The incremental cost-effectiveness ratios showed that sertindole was dominant only over olanzapine and was not cost-effective compared with risperidone and quetiapine. Various sensitivity analyses confirmed the results from the base-case analysis.ConclusionsSertindole may be considered a valuable treatment option for South Korean patients who have failed the therapy with other atypical antipsychotic agents.