Análisis de costes y consecuencias del tratamiento de la esquizofrenia con aripiprazol en España: proyección de sus efectos sobre la diabetes y la enfermedad coronaria (estudio STAR)

Abstract

Objetive: Patients with schizophrenia suffer from high rates of morbidity and mortality, in part due to the increased risk of diabetes and cardiovascular disease. The STAR study showed a reduced risk of metabolic adverse effects with aripiprazole compared with standard antipsychotic treatment (olanzapine, quetiapine, or risperidone). We estimated the costs and health consequences of both long-term treatments. Methods: Based on the STAR trial results, a projection for a period of 10 years of diabetes and coronary heart disease risk was carried out with Stern and Framingham models, respectively, in patients treated with standard therapy or aripiprazole. The prevalence and costs (direct and indirect) of diabetes and coronary heart disease (updated to 2012) were obtained from Spanish sources. Results: The number of diabetes cases avoided (23.4 cases per 1,000 patients treated) in patients treated with aripiprazole compared with standard treatment, would result in a saving of €16,565,145 (direct and indirect costs) in the Spanish population during a period of 10 years. Similarly, aripiprazole would prevent 3.7 cases of coronary heart disease per 1,000 patients treated, generating savings of €4,507,264 (direct and indirect costs) in 10 years. The total savings for Spain in that period would be €21,072,409 (direct and indirect costs). Conclusions: Compared with standard therapy, aripiprazole may reduce the incidence of diabetes and heart disease, and may generate substantial savings in the Spanish population as a result of its favorable metabolic profile.