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Atypical Injectable Antipsychotics for Schizophrenia or Bipolar Disorder: A Review of Clinical Effectiveness and Cost-Effectiveness

Last updated: January 3, 2019
Project Number: RC1053-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of atypical long-acting injectable antipsychotics for the treatment of patients with schizophrenia or bipolar disorder?
  2. What is the cost-effectiveness of atypical long-acting injectable antipsychotics for the treatment of patients with schizophrenia or bipolar disorder?

Key Message

The results of four systematic reviews (including one overview of systematic reviews, and one indirect comparison) were used to inform the clinical effectiveness of atypical long-acting injectable (LAI) antipsychotics for the treatment of patients with schizophrenia or bipolar disorder. Three systematic reviews (SRs) provided some evidence to suggest that aripiprazole LAI is clinically effective compared to placebo based on time to recurrence, any relapse, manic relapse, and the positive and negative syndrome scale (PANSS) outcomes. One SR provided evidence to suggest clinical effectiveness of paliperidone palmitate LAI compared to placebo based on PANSS outcomes. Generally, LAI formulations were not found to differ in clinical effectiveness compared to oral formations based on evidence for aripiprazole and risperidone.Two economic evaluations provided evidence to suggest cost-effectiveness of aripiprazole LAI over placebo, and an increase in market shares and increase in budget impact per member per month after 5 years.