The Use of Risperidone-combination and Haloperidol-combination in Schizophrenia Patients; a Cost Utility Analysis in Psychiatric Hospital of Prof. V. L. Ratumbuysang

Abstract Objective The aim of this research is to evaluate the cost and utility of the use of risperidone or haloperidol combinations on schizophrenic patients in the cases at Prof. V.L. Ratumbuysang Psychiatric Hospital North Sulawesi Province of Indonesia. Method This study was an observational study with a Cohort design. Sampling was done using a purposive sampling method for all 82 patients and finally obtained 22 patients for risperidone-combination group and 28 patients for haloperidol-combination group. Data was collected from patient's medical records by using retrospective approaches from April to July 2018 and prospectively by using a short form questionnaire. The utility based on the quality of life was assessed by the 36-item Short Form (SF-36) questionnaire. The quality-adjusted life years (QALY's) for haloperidol-combination were recorded as 0.433 which more high than risperidone-combination group, which recorded as 0.423 Average cost-effectiveness ratio (ACER) for the risperidone-combination group was IDR 5,813,716.13/QALY's, which more cost-effectively than the haloperidol-combination group of IDR 6,454,822.17/QALY's with the record of incremental cost-effective ratio (ICER) of IDR 33,573,600/QALY. Results The result of sensitivity test to 25% total cost increase for risperidone-combination group (IDR 7,267,145) and the 25% total cost decrease for haloperidol-combination group has change in ACER values with compared to the baseline of risperidone-combination group. Conclusion Risperidone-combination is the dominant therapeutic choice related to cost and QALY's in the treatment for schizophrenic patients.