Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T10:12:37.986Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-effectiveness of clozapine

A UK clinic-based study

Published online by Cambridge University Press:  03 January 2018

Katherine J. Aitchison  and
Robert W Kerwin
Katherine J. Aitchison*
Affiliation:
Institute of Psychiatry, London
Robert W Kerwin
Affiliation:
Institute of Psychiatry, London
*
Dr Katherine J. Aitchison, Section of Clinical Neuropharmacology, Department of Psychological Medicine, Institute of Psychiatry, Denmark Hill, London SE5 8AF. Fax: 0171 7019044; e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Schizophrenia is highly expensive in calculable and incalculable costs. Measures which impact the cost in the most severely affected are likely to produce the greatest cost reductions. Studies regarding clozapine in the USA have demonstrated clear cost-effectiveness, despite the high prescription costs. There are no prior UK studies.

Method

We performed a cost-effectiveness analysis comparing the three years prior to commencing clozapine to the period following establishment of clozapine treatment (mean 36.4 months) for 26 patients with chronic schizophrenia or schizoaffective disorder.

Results

There was a significant improvement in all clinical ratings applied (and a mean net saving of £3768 per annum). The cost-effectiveness of clozapine was double that of conventional neuroleptics (15.2 pre-, 33.0 post-clozapine, P < 0.005).

Conclusions

As a naturalistic study our data provide valuable information on the cost-effectiveness of clozapine in the UK. Our methodology could be applied in a community setting or in the study of another atypical neuroleptic.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 125 - 130
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

See editorial pp. 103–104, this issue.

References

REFERENCES

Department of Health, Education and Welfare (1974) Abnormal Involuntary Movements Scale (AIMS). Washington. DC: Alcohol. Drug Abuse, and Mental Health Administration; Department of Health Administration; Department of Health. Education and Welfare.Google Scholar
Allebeck, P. (1989) Schizophrenia: a life-shortening disease. Schizophrenia Bulletin, 15, 81–89.CrossRefGoogle ScholarPubMed
Anderson, C., Connelly, J., Johnstone, E. C., et al (1991) Disabilities and circumstances of schizophrenic patients: V. Cause of death. British Journal of Psychiatry, 159 (suppl. 13). 30–33.Google Scholar
Beecham, J. F. (1995) Collecting and estimating costs. In The Economic Evaluation of Mental Health Services (ed. M. R. J. Knapp), pp. 61–82. Aldershot: Arena.Google Scholar
Davies, L. M. & Drummond, M. F. (1994) Economics and schizophrenia: the real cost. British Journal of Psychiatry, 165 (suppl. 25). 18–21.CrossRefGoogle Scholar
Department of Health (1996) Burdens of Disease. A Discussion Document. London: DoH.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.Google Scholar
Guest, J. F., Hart, W. M., Cookson, R. F., et al (1996) Pharmacoeconomic evaluation of long-term treatment with risperidone for patients with chronic schizophrenia. British Journal of Medical Economics, 10, 59–67.Google Scholar
Heinrichs, D. N., Hanton, T. E. & Carpenter, W. T. (1984) The quality of life scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10, 388–398.Google Scholar
Honigfeld, G. & Patin, J. (1990) A two-year clinical and economic follow-up of patients on clozapine. Hospital and Community Psychiatry, 41, 882–885.Google ScholarPubMed
Johnstone, E. C., Owens, D G. C. & Leary, J. (1991) Disabilities and circumstances of schizophrenic patients. VI: Comparison of the 1975–85 cohort with the 1970–75 cohort. British Journal of Psychiatry, 159 (suppl. 13). 34–36.Google Scholar
Kane, J., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Archives of General Psychiatry, 45, 789–796.CrossRefGoogle ScholarPubMed
Kane, J., (1992) Clinical efficacy of clozapine in treatment-refractory schizophrenia: an overview. British Journal of Psychiatry, 160 (supp. 17), 41–45.CrossRefGoogle Scholar
Lieberman, J. A., Safferman, A. Z., Pollack, S., et al (1994) Clinical effects of clozapine in chronic schizophrenia: response to treatment and predictors of outcome. American Journal of Psychiatry, 151, 1744–1752.Google Scholar
Martin, C. (1996) Impact of olanzapine on quality of life in schizophrenia. European Journal of Psychiatry, 11 (suppl. 4). 252.CrossRefGoogle Scholar
Matheson, L. A., Cook, H. M., McKenna, P., et al (1994) Value for money for patients with schizophrenia. British Journal of Medical Economics, 7, 25–34.Google Scholar
Maynard, A. (1993) Cost management: the economists viewpoint. British Journal of Psychiatry, 163 (suppl. 20). 7–13.Google Scholar
Meltzer, H. Y., Cola, P., Way, L., et al (1993) Cost-effectiveness of clozapine in neuroleptic-resistant schizophrenia. American Journal of Psychiatry, 150, 1630–1638.Google Scholar
Netten, A. (1994) Unit Costs of Community Care 1994. Canterbury: Personal Social Services Research Unit.Google Scholar
Overall, J. E. & Gorham, D. E. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799–812.CrossRefGoogle Scholar
Prudo, R. & Bluhm, H. M. (1987) Five-year outcome and prognosis in schizophrenia. British Journal of Psychiatry, 150, 345–354.Google Scholar
Reid, W. H., Mason, M. & Topral, M. (1994) Savings in hospital bed days related to treatment with clozapine. Hospital and Community Psychiatry, 45, 261–264.Google ScholarPubMed
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, 41, 850–854.Google ScholarPubMed
Royal College of Psychiatrists (1996) Report of the Confidential Inquiry into Homicides and Suicides by Mentally III People. London: Royal College of Psychiatrists.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.