Clinical Drug Investigation

, Volume 36, Issue 6, pp 479–490 | Cite as

Cost-Minimisation Analysis of Paliperidone Palmitate Long-Acting Treatment versus Risperidone Long-Acting Treatment for Schizophrenia in Spain

  • Javier Quintero
  • Itziar Oyagüez
  • Beatriz González
  • Ignacio Cuervo-Arango
  • Ignacio García
  • Miguel Angel Casado
Original Research Article


Background and Objective

Long-acting formulations for paliperidone (PPLAT) and risperidone (RLAT) are effective second-generation antipsychotics. This study aimed to compare treatment costs between PPLAT and RLAT in schizophrenia patients.


A cost-minimization analysis was performed from the perspective of the Spanish National Healthcare System (NHS), in line with the approach accepted by the Scottish Medicine Consortium evaluation. Only direct health costs (€, 2015) were included, i.e. medication (including oral antipsychotic drug supplementation), hospitalization and cost of administration in the community. Two time horizons were used: 1 year (to compare initiation treatment) and 2 years (to compare maintenance treatment). Base-case considered the following assumptions: setting for treatment initiation (50 % hospital and 50 % community); 50 % of patients initiating from a long-acting treatment and 50 % from an oral antipsychotic; no reduction in the length of stay. One-way sensitivity analyses (SA) were performed.


The estimated costs/patient were €7698 (PPLAT) and €8168 (RLAT) for the first year, and €4314 (PPLAT) and €5003 (RLAT) for the second year. Cost savings related to PPLAT therapy were €470 and €689 for first and second year, respectively. SA results confirmed the robustness of the model results, even in the most conservative scenarios: (1) if 100 % of patients initiate treatment in hospital, the savings could be €454 per patient; (2) if 100 % of patients initiate treatment from an oral antipsychotic, the savings could be €277 per patient/year; and (3) if PPLAT could not reduce the length of stay by approximately one-third, as some studies indicate, the savings could be €470 per patient/year.


The use of PPLAT instead of RLAT could be a cost-saving strategy for the Spanish NHS.


Schizophrenia Risperidone Paliperidone Define Daily Dose Paliperidone Palmitate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards

Conflicts of interest

Beatriz Gonzalez, Ignacio Cuervo-Arango, and Ignacio Garcia are employees of Janssen–Cilag. Itziar Oyagüez and Miguel Angel Casado are employees of Pharmacoeconomics & Outcomes Research Iberia (PORIB), a consultant company specialising in healthcare outcome research, and were funded by Janssen–Cilag to assist with the local adaptation of the model and manuscript writing. Javier Quintero is part of an advisory board funded by Janssen–Cilag to validate local clinical practice.


This analysis was funded by Janssen–Cilag.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Javier Quintero
    • 1
  • Itziar Oyagüez
    • 2
  • Beatriz González
    • 3
  • Ignacio Cuervo-Arango
    • 3
  • Ignacio García
    • 3
  • Miguel Angel Casado
    • 2
  1. 1.Hospital Universitario Infanta LeonorMadridSpain
  2. 2.Pharmacoeconomics & Outcomes Research IberiaMadridSpain
  3. 3.Janssen-CilagMadridSpain

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