PDG9 Cost Effectiveness Analysis of Blonanserin Versus Olanzapine As First-LINE Treatment for Patients with Schizophrenia in China

This study aimed to assess the cost-effectiveness of blonanserin compared to olanzapine as first-line treatment for patients with schizophrenia in China. A 10-state Markov model with monthly cycle was constructed to estimate the lifetime incremental cost-effectiveness ratio (ICER) from China health care system perspective. Patients with schizophrenia received blonanserin or olanzapine as first-line treatment and switched to risperidone and clozapine as second-line and third-line treatment respectively due to symptoms relapse. Efficacy and safety data were derived from network meta-analysis. As the main clinical inputs in the model, probabilities of experience recurrences were extrapolated from a retrospective cohort study. The costs obtained both from real world data and local published resources comprised drugs, administration, adverse events management, follow-up and therapeutic costs. Costs and outcomes were both discounted at 5%. Sensitivity analysis were conducted to verify the robustness of the results. Blonanserin provided 6.48 QALYs at a cost of CNY 504,343, whereas olanzapine provided 6.28 QALYs at a cost of CNY 488,565. Compared to olanzapine, the ICER of blonanserin was CNY 78,238/QALY, which was between 1∼2 times GDP per capita, far below the local threshold of 3 times GDP per capita in 2019 (CNY 212,946). One-way sensitivity analysis showed the results were generally robust. Probabilistic sensitivity analysis showed that blonanserin, compared with olanzapine, was more cost-effective in above 80% simulations at local threshold. Compared to olanzapine, blonanserin is more cost-effective as first-line treatment for patients with schizophrenia in China.