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The health economic implications of treatment with quetiapine: an audit of long-term treatment for patients with chronic schizophrenia

Published online by Cambridge University Press:  16 April 2020

J. Lynch ,
J. Morrison ,
N. Graves ,
D. Meddis ,
M.F. Drummond  and
J.S.E. Hellewell
J. Lynch
Affiliation:
St Lukes Hospital, Clonmel, Republic of Ireland
J. Morrison
Affiliation:
St Lukes Hospital, Clonmel, Republic of Ireland
N. Graves
Affiliation:
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
D. Meddis*
Affiliation:
AstraZeneca, Mereside, Alderley Park, Macclesfield, CheshireSK10 4TG, UK
M.F. Drummond
Affiliation:
Centre for Health Economics, University of York, York, UK
J.S.E. Hellewell
Affiliation:
Trafford General Hospital, Manchester, UK
*
*Correspondence and reprints.
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Summary

This retrospective, case series audit assessed the clinical and health-economic impact of long-term treatment with quetiapine (‘Seroquel’), a new atypical antipsychotic, in patients with chronic schizophrenia.

The study design was of a case series format, comprising patients entered from one centre into the open-label extension of a multicentre 6-week efficacy study. Twenty-one patients (15 male, six female; mean age 39 years) were studied, of whom 17 (81%) had been rated as ‘partially responsive’ to previous antipsychotics. Data on hospitalisations and information on symptoms were collected retrospectively for the 12 months before quetiapine treatment was initiated and for the 12 months after.

Quetiapine was effective in reducing psychotic symptoms with mean BPRS scores reducing significantly, from 38 to 21 (P < 0.005). Motor function was also significantly improved with mean Simpson scale scores reducing from 15 to 12 (P < 0.005). Average inpatient days were reduced by 11% in year two (97 compared with 109 days) while the overall costs of treatment, including drug costs, fell by 5% (I£20,843 to I£19,827).

Four patients had been hospitalised for longer than 5 years before starting quetiapine; these chronically institutionalised patients remained in hospital, despite improved clinical outcomes (mean BPRS scores after treatment of 34, compared with 43 before), for the full 12 months of quetiapine treatment. Were the data from this audit to be re-analysed excluding these four patients then average inpatient days would have been reduced by 33% (45 to 30 days) and overall cost of treatment by 19% (I£8617 to I£7011).

This audit suggests that treatment with quetiapine over this 1-year period was associated with both clinical improvements and a decreased usage of inpatient services. The reduction in hospitalisation costs would appear to compensate for the increased cost of drug treatment. Significantly, potential savings appear to be greatest for those patients with a ‘revolving door’ pattern of repeated readmission.

Keywords

antipsychoticaudithealth economicsquetiapineschizophrenia
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 5 , August 2001 , pp. 307 - 312
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

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