Real-World Cost-analysis of Paliperidone Palmitate for Schizophrenia Management:A Retrospective Analysis in Xiamen, China

Background: To perform a cost-analysis of one-year maintenance treatment in stable schizophrenic patients with paliperidone extended-release tablets (PPER) and paliperidone palmitate once-monthly (PP1M) and provide a reference for clinicians in patient selection. Methods: A retrospective investigation and analysis were conducted on stable schizophrenic patients who had been on PPER or PP1M for at least one year between June 2014 and December 2019 in Xiamen City. Patient demographic data, direct medical and nonmedical costs, and other information were collected. The clinical efficacy data were obtained from published articles, and a cost-effectiveness analysis was conducted. Results: The PPER and PP1M groups included data from 84 and 62 patients, respectively. The two groups had no significant difference in gender and age. The total effective rates of PPER and PP1M were 73.17 and 97.37%, respectively. The registration frequency in the PPER group was significantly higher than that in the PP1M group ( P <0.001). The cost of medication and total treatment was significantly higher in the PP1M group than in the PPER group (P <0.001). The cost/effect value was slightly higher in the PP1M group than in the PPER group. The incremental cost-effect ratio of both treatments was 369.07 yuan, less than the per capita gross domestic product (GDP) value. Conclusion: Both formulations of paliperidone were found to be suitable for the long-term management of schizophrenia, while PP1M has better pharmacoeconomic advantages.