Clinical and Cost Consequences of Metabolic Effects of Lurasidone Versus Other Atypical Antipsychotics in Schizophrenia

Krithika Rajagopalan1, Shien Guo*, 2, Luis Hernandez2, Julia Green2, Antony Loebel1
1 Sunovion Pharmaceuticals, Marlboro, MA, USA
2 Evidera, Lexington, MA, USA

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© Rajagopalan et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Evidera, 430 Bedford St., Suite 300, Lexington, MA 02420, USA; Tel: (781) 960-0229; Fax: (781) 761-0147; E-mail:



To estimate the economic burden of hyperglycemia and diabetes associated with lurasidone versus other atypical antipsychotics in schizophrenia.


A discrete event simulation model was developed to conduct the analysis from both US payer and societal perspectives over a 3-year timeframe. The model, based on the values of metabolic parameters at 1 year of treatment, identified patients with hyperglycemia at that point and predicted incident cases of diabetes over 3 years using a risk equation from the Framingham Heart Study. Direct and indirect costs of diabetes and hyperglycemia were estimated, according to patients’ disease status over time. Data on metabolic changes at 1 year were mainly from 4 clinical studies of lurasidone, supplemented with published data for other atypical antipsychotics. Cost inputs (2012 US dollars) were obtained from published sources.


Compared with olanzapine, risperidone, and quetiapine XR, lurasidone was predicted to result in 2,785,351, and 847 fewer hyperglycemia cases and 1,142,153, and 67 fewer incident diabetes cases per 10,000 patients over 3 years, respectively. Consequently, there was a reduction in the economic burden of diabetes and hyperglycemia by approximately $23 million, $2.9 million, and $3.4 million from a US payer perspective, and $28 million, $3.6 million, and $3.7 million from a societal perspective.


Adverse metabolic effects of atypical antipsychotics could have substantial unfavorable clinical and economic consequences. Lurasidone may reduce these burdens and may be a treatment alternative for patients with schizophrenia.

Keywords: : Atypical antipsychotics, discrete event simulation, economic evaluation, lurasidone, metabolic effect, schizophrenia.