Invega (paliperidone) prolonged-release tablets are approved in treatment of schizophrenia. Paliperidone is an active metabolite of the atypical antipsychotic risperidone (Risperdal) whose patent just ran out. The effect and side effect profile correspond to that substance, but paliperidone has not been compared with risperidone in clinical studies.
The effect of a normal daily dose of 6 mg is measured on the primary endpoint, total PANSS-score, is significantly better than placebo and in short-term studies at the same level as 10 mg of olanzapine. The risk of recurrence over a period of 52 weeks is also lesser with Invega than in treatment with placebo (25 vs. 53 %).
The most common side effects are, as for risperdone, headache, tachycardia, insomnia, dizziness, orthostatic hypotension and others, and in high doses (9 and 12 mg) among others extrapyramidal disorder (EPS) and increased weight.
The price for a daily dose of Invega (6 mg) is 45,95 Dkr. which is on a par with 10 mg olanzapin (Zyprexa). But the price is 18 times as high as the cheapest atypical antipsycotic, risperidone (generic Risperdal). Risperidone costs 2,60 Dkr. for one daily dose (4 mg). Simultaneously is it 10-20 times more expensive than traditional antipsychotics ( e.g. perfenazine). The price increases to 76,70Dkr. when 9 mg of Invega is prescribed daily, which barely is 30 times higher than a equieffective dose of risperidone.
As effect and side effects apparently are almost similar to risperidone, and the price is many times higher, IRF does not recommend Invega as a routine treatment.
Invega is covered under the rules on general reimbursement.
Invega was marketed the 22 of October 2007.