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Assessment of Costs and Benefits of Drug Therapy for Treatment-Resistant Schizophrenia in the United Kingdom

Published online by Cambridge University Press:  03 January 2018

Linda M. Davies  and
Michael F. Drummond
Linda M. Davies*
Affiliation:
Centre for Health Economics, University of York, Heslington, York YO1 5DD
Michael F. Drummond
Affiliation:
Centre for Health Economics, University of York, Heslington, York YO1 5DD
*
∗Correspondence
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Abstract

An analysis was conducted on the basis of available data to assess the economic consequences of clozapine therapy for people with moderate to severe schizophrenia in long-stay institutions or staffed group homes, with a view to providing an estimate of the likely costs and benefits of the drug. Data from a cost-effectiveness study conducted in the US, supplemented by other literature sources, were used to construct a clinical decision tree for likely clinical outcomes for such patients. A panel of UK psychiatrists provided consensus on how these patients would have been managed in the UK. The costs associated with each patient outcome were estimated, and a sensitivity analysis performed to test the assumptions made. For the patients themselves, clozapine would lead to a net gain of 5.87 years of life with no disability or only mild disability. The base case analysis showed that the direct costs of using clozapine were £91 less per annum (or £1333 per lifetime) than for standard neuroleptic therapy, when the effect on all health-care resources was taken into account. In addition, the sensitivity analysis showed that clozapine would be cost-saving or cost-neutral under many different assumptions. A prospective health economic study with clozapine in the management of schizophrenia would be desirable to confirm these results.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 1 , January 1993 , pp. 38 - 42
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Chartered Institute for Public Finance and Accountancy (1987) Health Services Trends. London: Healthcare Financial Management Association.Google Scholar
Claghorn, J., Honigfeld, G., Abuzzahab, F. S., et al (1987) The risks and benefits of clozapine versus chlorpromazine. Journal of Clinical Psychopharmacology, 7, 377–384.Google Scholar
Cooper, J. E. (1991) Schizophrenia and allied conditions. Medicine International, 94, 3917–3922.Google Scholar
Davies, L. M. (1988) Community care – the costs and quality. Health Services Management Research, 1, 145–155.Google Scholar
Davies, L. M. & Drummond, M. F. (1990) The economic burden of schizophrenia. Psychiatric Bulletin, 14, 522–525.Google Scholar
Department of Health (1988) Health and Personal Social Services in England. London: HMSO.Google Scholar
Department of Health and Social Security (1984) Inpatient Statistics from Mental Health Enquiry for England, 1981. London: HMSO.Google Scholar
Drummond, M. F., Stoddart, G. L. & Torrance, G. W. (1987) Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press.Google Scholar
Fischer-Cornelssen, K. A. & Ferner, U. J. (1976) An example of European multi-centre trials: multispectral analysis of clozapine. Psychopharmacology Bulletin, 12, 34–39.Google Scholar
Honigfeld, G., Patin, J. & Singer, J. (1984) Antipsychotic activity in treatment-resistant schizophrenics. Advanced Therapy, 1, 77–97.Google Scholar
Kane, J., Honigfeld, G. & Singer, J. (1988) Clozapine for the treatment resistant schizophrenic. Archives of General Psychiatry, 45, 789–796.Google Scholar
Kuha, S. & Miettinen, E. (1986) Long term effect of clozapine in schizophrenia: a retrospective study of 108 chronic schizophrenics treated with clozapine for up to 7 years. Nord Psychiatr Tidske, 40, 225–230.Google Scholar
Lindstrom, L. H. (1988) The effect of long term treatment with clozapine in schizophrenia: a retrospective study in 96 patients treated with clozapine for up to 13 years. Acta Psychiatrica Scandinavica, 77, 524–529.Google Scholar
Marder, S. R. & van Putten, T. (1988) Who should receive clozapine? Archives of General Psychiatry, 45, 865–867.Google Scholar
Office of Health Economics (1987) Compendium of Health Statistics. London: Office of Health Economics.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799–812.Google Scholar
Povlsen, U. J., Noring, U., Fog, R., et al (1985) Tolerability and therapeutic effect of clozapine. Acta Psychiatrica Scandinavica, 71, 176–181.Google Scholar
Revicki, D. A., Luce, B. R., Weschler, J. M., et al (1990) Cost effectiveness of clozapine for treatment-resistant schizophrenic patients. Hospital and Community Psychiatry, 1, 850–854.Google Scholar
Review Body for Nursing Staff, Midwives, Health Workers and Professions Allied to Medicine (1989) 6th Report on Nursing Staff, Midwives and Health Visitors, cmnd 577. London: HMSO.Google Scholar
Rosenstein, M. J., Milazzo-Sayre, L. J. & Manderscheid, R. W. (1988) Care of Persons with Schizophrenia: A Statistical Profile. Bethesda: Survey and Reports Branch, Division of Biometry and Applied Sciences, National Institute of Mental Health.Google Scholar
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