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Economic and health state utility determinations for schizophrenic patients treated with risperidone or haloperidol.

https://arctichealth.org/en/permalink/ahliterature207881
Source
J Clin Psychopharmacol. 1997 Aug;17(4):298-307
Publication Type
Article
Date
Aug-1997
Author
G. Chouinard
P S Albright
Author Affiliation
Department of Psychiatry, University of Montreal, Quebec, Canada.
Source
J Clin Psychopharmacol. 1997 Aug;17(4):298-307
Date
Aug-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antipsychotic Agents - adverse effects - economics - therapeutic use
Canada
Chronic Disease
Cost-Benefit Analysis
Double-Blind Method
Female
Haloperidol - adverse effects - economics - therapeutic use
Health status
Humans
Male
Middle Aged
Quality-Adjusted Life Years
Retrospective Studies
Risperidone - adverse effects - economics - therapeutic use
Schizophrenia - drug therapy - economics - physiopathology
Schizophrenic Psychology
Abstract
The current study uses utility analysis to assess economic and quality-of-life benefits of risperidone in patients with chronic schizophrenia. A retrospective analysis was performed on Positive and Negative Syndrome Symptoms (PANSS) data obtained from the published Canadian multicenter risperidone trial (part of the North American trial). Cluster analysis applied to endpoint PANSS scores, including all patients (N = 135), identified three clusters representing 130 patients with mild, moderate, and severe symptomatology. A narrative health state profile was written for each cluster, and 100 psychiatric nurses from Washington, DC, were asked to assign preference ratings to each one using linear analog and standard gamble (SG) methods. Mean utility values (confidence interval 95%) obtained from the SG ratings for the three health state profiles were 0.61 +/- 0.069 (mild); 0.36 +/- 0.073 (moderate); and 0.29 +/- 0.071 (severe). The mild health state (including the majority of risperidone 6 mg-treated patients) was rated by nurses to have a 0.25 +/- 0.0501 greater utility than the moderate health state (composed of the majority of haloperidol-treated patients). The results of these utility evaluations (SG) by the nurses were related to the clinical outcome for three of the six drug treatment groups (N = 65) by multiplying the percentage of patients in each of the three clusters, both at baseline and end-point, who were receiving risperidone 6 mg/day, haloperidol, or placebo, by the utility value for the health state assigned to that cluster. The gain in utility for risperidone-treated patients was 2.6 times higher (0.125) compared with haloperidol-treated patients (0.049), and 7 times higher compared with placebo (-0.021). After multiplying the gain in utility of each treatment by the remaining expected life span for men and women, it was found that risperidone-treated patients obtained more than twice as many quality-adjusted years as haloperidol patients. The incremental drug treatment cost divided by the incremental benefit of risperidone versus haloperidol was found to yield a favorable, generally accepted cost-utility ratio.
PubMed ID
9241010 View in PubMed
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Resource utilization in a Canadian national study of people with schizophrenia and related psychotic disorders.

https://arctichealth.org/en/permalink/ahliterature170222
Source
Acta Psychiatr Scand Suppl. 2006;(430):29-39
Publication Type
Article
Date
2006
Author
L. Kopala
G. Smith
A. Malla
R. Williams
L. Love
D. Talling
R. Balshaw
Author Affiliation
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. lkopala@dal.ca
Source
Acta Psychiatr Scand Suppl. 2006;(430):29-39
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Antipsychotic Agents - adverse effects - economics - therapeutic use
Benzodiazepines - adverse effects - economics - therapeutic use
Canada
Clozapine - adverse effects - economics - therapeutic use
Cohort Studies
Cost of Illness
Cost-Benefit Analysis - statistics & numerical data
Dibenzothiazepines - adverse effects - economics - therapeutic use
Drug Costs
Female
Health Care Surveys
Health Resources - utilization
Humans
Male
Prospective Studies
Psychotic Disorders - drug therapy - economics
Risk assessment
Risperidone - adverse effects - economics - therapeutic use
Schizophrenia - drug therapy - economics
Abstract
To determine how the use of the newer, so called atypical antipsychotic medications, effects the pharmacoeconomic treatment burden of schizophrenia and related conditions and to provide a clear comparison of the costs and risks associated with these atypical drugs.
In this 2-year, open-label, prospective study, resource utilization (RU) data were collected on 160 patients with these conditions. A comparison between risks and costs was performed by combining the generalized CNOMSS data on both economic factors and risk assessments.
The main findings of the study were that the total adjusted 1- and 2-year costs were lowest for quetiapine. Drug acquisition costs were lowest for risperidone for both the 1- and 2-year cohorts. Clozapine use was predictably associated with the highest overall and medication costs at both 1 and 2 years.
Treatment with risperidone or quetiapine was associated with the lowest overall costs when compared with olanzapine or clozapine.
PubMed ID
16542323 View in PubMed
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