Cost-effectiveness of a free drug program for schizophrenia in Beijing, China.

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Cost-effectiveness of a free drug program for schizophrenia in Beijing, China.

Int J Soc Psychiatry. 2019 Feb;65(1):28-37

Authors: Yan F, Yang Y, Huang Q, Chen Y, Jia P, Chen W, Ma X

Abstract
BACKGROUND:: Beijing municipal government launched a Free Drug Program (FDP) in 2013 to reduce the financial burden of schizophrenia patients.
OBJECTIVES:: To assess the cost-effectiveness of a FDP designed for schizophrenia patients in Beijing, China.
METHODS:: In all, 2007 schizophrenia patients enrolled in an FDP (FDP group) and 2001 schizophrenia patients who were not enrolled (non-FDP group) were randomly selected for a cross-sectional survey in August 2015. The study sought to develop a cost-effectiveness model to assess the FDP from the societal perspective in Beijing, China. Scenario analyses explored the potential strategies to further improve the cost-effectiveness of the FDP.
RESULTS:: The FDP group was associated with lower socioeconomic status and more advanced disease than the non-FDP group (unemployment rate: 48.8% vs 37.3%, p < .001; disability rate: 91.2% vs 64.1%, p < .001; overall comorbidity rate: 34.9% vs 28.8%, p < .001). The two groups exhibited similar disease severity and quality of life. However, the FDP group was associated with significantly lower direct medical costs (coefficient -.342, p = .003) and indirect costs (coefficient -.473, p < .001) than the non-FDP group. The base case incremental cost-effectiveness ratio (ICER) per gained quality-adjusted life year (QALY) for the FDP group relative to the non-FDP group was 1.480 times of 2015 China's gross domestic product per capita. Home drug delivery and long-lasting injection treatment could reduce the ICER for the FDP group relative to the non-FDP group by 57.8% and 29.8%, respectively.
CONCLUSION:: The FDP was attractive to schizophrenia patients with lower socioeconomic status and more advanced disease. The cost-effectiveness of the FDP was acceptable and could be further improved by home drug delivery and long-lasting injection treatment.

PMID: 30791795 [PubMed - in process]

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