Budget impact analysis of long-acting injections for the treatment of Schizophrenia in Japan

Background

Following policy changes implemented in April 2020 in Japan, long-acting injectable antipsychotics (LAI-As) have been reimbursed as a part of a government initiative for community-oriented mental health care. This study assessed the financial impact of increased LAI-A usage compared to the current LAI-A and oral antipsychotic (OA) usage for the treatment of adult patients with schizophrenia.

Methods

A budget impact (BI) model was developed to estimate the BI of increased LAI-A usage from the Japanese healthcare payor perspective over five years. The inputs were informed by the most recent available data reflecting the current reimbursement structure and treatment practices. The model considered drug acquisition, administration visit, psychotherapy, and hospitalization costs. Scenario and sensitivity analyses were conducted.

Results

Increasing LAI-A uptake by 10 % from current usage each year resulted in a BI of ¥886,001,060 (0.09 % increase) over five years. Hospitalization and drug acquisition costs constituted 84.1 % and 9.4 % of the total cost, respectively. Variation in the hospitalization inputs for patients on OAs and LAI-As had the greatest impact on the net budget, ranging from being cost saving to resulting in a small positive BI.

Conclusion

Increased utilization of LAI-As for schizophrenia treatment in Japan has a minimal BI. Despite the increased drug acquisition and administration visit costs, the decreased hospitalization costs offset the overall impact. Altogether, these findings support the continued reimbursement and usage of LAI-As aligned with the recent policy changes.