Cost effectiveness analysis of blonanserin versus ziprasidone as first-line treatment for patients with schizophrenia in China

Background and Objectives: The aim of the study is to evaluate the cost-effectiveness of blonanserin compared with ziprasidone as first-line treatment for patients with schizophrenia in China. Methods: A 10-state Markov model was built to assess the long-term cost-effectiveness of blonanserin from China health care system perspective. A time horizon of 10 years with monthly cycle was chosen. Patients with schizophrenia will receive blonanserin or ziprasidone as first-line treatment and could switch to olanzapine or clozapine as second-line or third-line treatment when symptoms relapse happens. Efficacy and safety data were derived from network meta-analysis. Probabilities of experience recurrences were derived from a retrospective cohort study. The costs were obtained from real world data and local published resources. Costs and outcomes were both discounted at 5%. Sensitivity analysis were conducted to verify the robustness of the results. Results: Blonanserin generated 4.30 quality-adjusted life-years (QALYs) with cost of Chinese Yuan (CNY) 167,011, whereas ziprasidone generated 4.28 QALYs with cost of CNY 173,575. Compared with ziprasidone, blonanserin was seen as the dominant treatment. One-way sensitivity analysis demonstrated the robustness of the base case results. Probabilistic sensitivity analysis showed that blonanserin was a cost-effective strategy in more than 70% simulations under the local threshold compared with ziprasidone. Conclusions: Compared with ziprasidone, blonanserin is cost-effective as first-line treatment for patients with schizophrenia in China.