Evidence review: economic issues

Evidence review: economic issues

Cost effectiveness

No cost-effectiveness studies of omega-3 fatty acids for use in schizophrenia were identified.

Cost

The costs of omega-3 fatty acid medicines are given in the table below.

Omega-3 fatty acid medicine

Cost

Omacor 1000 mg capsules

(comprising 460 mg E-EPA and 380 mg DHA)

£14.24 for 28 capsulesa

£50.84 for 100 capsulesb

Teromeg 1000 mg capsules

(comprising 460 mg E-EPA and 380 mg DHA)

£11.39 for 28 capsulesb

£40.67 for 100 capsulesb

Maxepa 1000 mg capsules

(comprising 170 mg EPA and 115 mg DHA)

£29.28 for 200 capsulesa

Abbreviations: DHA, docosahexaenoic acid; E-EPA, ethyl-eicosapentaenoic acid; EPA, eicosapentaenoic acid.

a NHS electronic drug tariff, August 2013 (excluding VAT).

b MIMS, August 2013 (excluding VAT).

The dosing regimen used most frequently in the randomised controlled trials (RCTs) in this evidence summary was 2 g or 3 g of eicosapentaenoic acid (EPA) or ethyl-eicosapentaenoic acid (E-EPA) per day. A dose of 2 g of E-EPA per day is approximately 4 capsules of Omacor per day. The Maudsley Prescribing Guidelines in Psychiatry (11th edition) recommends a dose of 5 capsules daily for Omacor, or 10 capsules daily for Maxepa, when treating schizophrenia. The cost of these dosing regimens for 28 days would be £71.18 for Omacor, £56.94 for Teromeg and £40.99 for Maxepa.

Current drug usage

Prescription cost analysis for England (2012) showed that there were 589,600 items of omega-3-acid ethyl esters (Omacor and generic EPA/DHA capsules) dispensed in England in 2012 at a cost of £14,258,200. In addition, 28,400 items of omega-3 marine triglycerides (Maxepa capsules and liquid) were dispensed at a cost of £770,800. It is not known for which indications these items were prescribed.