Budget impact of aripiprazole once every 2 months long-acting injectable for adult patients with schizophrenia in the United States.

Background: Schizophrenia is a chronic psychiatric disorder, affecting 1.1% of the adult population in 2020 in the United States. Antipsychotic treatment is commonly used in schizophrenia management to help reduce the likelihood of symptom recurrence and relapse. Aripiprazole once every month, a long-acting injectable antipsychotic formulation with an established efficacy and safety profile, is approved by the United States Food and Drug Administration as a maintenance treatment for schizophrenia. A new ready-to-use formulation of aripiprazole for administration once every 2 months (Ari 2MRTU) has been shown to have similar efficacy to aripiprazole once every month and was designed to improve medication adherence in order to provide antipsychotic treatment and prevent relapses.

Objective: To estimate the financial impact of introducing Ari 2MRTU as a treatment option for adult patients diagnosed with schizophrenia in the United States.

Methods: A cohort of adult patients with schizophrenia was selected from a hypothetical health plan of 1 million members. Treatment costs were modeled with a 3-year time horizon from 2024 to 2026, in scenarios with or without the addition of Ari 2MRTU. Inputs into the model included estimated current and projected market share of the available antipsychotics, expected uptake of Ari 2MRTU, as well as the acquisition, initiation, and administration costs, hospitalization costs, time on treatment, and patient member medication adherence. The budget impact was estimated as the difference in the annual cost for the total cohort for the current and new scenarios, the cost per member per month and per treated member per month. Deterministic sensitivity analyses were conducted to examine the extent to which the model results were affected by a change in individual all-input parameters.

Results: The total budget impact of Ari 2MRTU being adopted as an alternative maintenance monotherapy for treating eligible patients with schizophrenia from a hypothetical US health plan of 1 million members was estimated to be a saving of $26,998 over 3 years. This represented a per member per month saving of $0.001 and a per treated member per month saving of $0.11, whereas a sensitivity analysis indicated that these savings were sensitive to treatment adherence and the acquisition cost of the new formulation.

Conclusions: The introduction of Ari 2MRTU as a maintenance treatment for adults with schizophrenia is expected to be cost neutral (with a modest saving) with respect to payer budgets in the United States. This merits consideration as is a potentially favorable option for patients who benefit from less frequent dosing.