Фармакоэкономический анализ поддерживающей терапии сероквелем, рисполептом и зипрексой больных с первым эпизодом шизофрении

Background: Rational choice of atypical antipsychotic in 'target' groups determines minimal medical costs and achieving the maximum clinical effect of treatment. Method: Mathematical (Markov) analysis cost-utility of a 5-year maintenance therapy with Seroquel, Rispolept and Zyprexa in patients with first episode of disease. Results: The profiles of adverse effects of the agents compared strongly influence the clinical and economic efficacy of treatment. On parameters of utility, safety and tolerability Seroquel was superior to Zyprexa and Rispolept; medical costs in using Seroquel and Rispolept were similar (397,5 and 406,4 thousand roubles, 2005) while Zyprexa happened to be more expensive (519,8 thousand roubles). The utility of Rispolept, Seroquel and olanzapine treatment was respectively 2,855, 3,055 and 2,928 QALY. The ratio costs / utility (1 QALY) for Rispolept, Seroquel and Zyprexa was respectively139,3, 133,0 and 177,5 thousand roubles. The cost for adding 1 QALY, if compared to Rispolept treatment, was for Seroquel respectively 43,68 and 1691,5 thousand roubles. The advantages of Seroquel persisted within the wide range of changes of the main parameters. Conclusions: Seroquel can be considered as a medication of choice for maintenance treatment of patients with first schizophrenic episode, especially those with high risk for extrapyramidal and some metabolical (weight gain) adverse effects.