ANÁLISIS COSTO-BENEFICIO DE CUATRO MEDICAMENTOS ANTIPSICÓTICOS EN PACIENTES CON ESQUIZOFRENIA EN COLOMBIA
Palabras clave:
risperidona, depósito, antipsicóticos, esquizofrenia, costo-beneficio, risperidone, depot, antipsychotics, schizophrenia, cost-benefitResumen
RESUMEN
Por la menor incidencia de efectos secundarios extrapiramidales y por una mayor adherencia de los pacientes al tratamiento, los antipsicóticos atípicos de liberación prolongada constituyen una alternativa para el tratamiento de la esquizofrenia. En este análisis de costo-beneficio se compara un antipsicótico atípico de liberación prolongada (risperidona) con dos medicamentos orales de nueva generación (olanzapina y clozapina) y uno típico de depósito (pipotiazina).
Se empleó un modelo de árbol decisión que incorporó exclusivamente costos directos, desde la perspectiva de una EPS (“tercero pagador”) y empleando las ivariables adherencia, recaídas con y sinhospitalización, y efectos adversos. Según el modelo, el empleo de risperidona inyectable de liberación prolongada durante un año de tratamiento, y de manera similar a la clozapina, ahorraría un millón de pesos al sistema al compararse con la olanzapina, y dos millones al compararse con la pipotiazina.
A esta ganancia en dinero con la risperidona inyectable se agregaría el beneficio directo e Indirecto para el paciente y su comunidad al reducir las recaídas.
Palabras clave: risperidona, depósito, antipsicóticos, esquizofrenia, costo-beneficio.
Summary
Due to the lower incidence of extrapyramidal side effects and greater adherence of patients to treatment, long-action atypical antipsychotics are an alternative for the treatment of schizophrenia. In this cost-benefit analysis we compare a long-action atypical antipsychotic (risperidone) with two second-generation oral antipsychotics (olanzapine and clozapine) and a “typical” prolonged action drug (pipotiazine).
We designed a decision tree that included only direct costs, from the third party payer perspective, using as main variables adherence, relapses with and without hospitalization, and side effects. According to the model, the use of long acting risperidone injection or clozapine over a one-year period, save around $1 million pesos (US$500) to the system when compared with olanzapine, and two million (US$1000) when compared with pipotiazine.
This economic benefit with risperidone injection would be added to the direct and indirect benefits to the patient and his community due to relapse reduction.
Keywords: risperidone, depot, antipsychotics, schizophrenia, cost-benefit
Biografía del autor/a
Diego Rosselli, Academia Nacional de Medicina
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