Lewis M, McCrone P, Frangou S
Section of Neurobiology of Psychosis, Institute of Psychiatry, De Crespigny Park, London, England.
J Clin Psychiatry. 2001 Oct;62(10):749-56. doi: 10.4088/jcp.v62n1002.
The high acquisition cost of the atypical antipsychotics has prompted their closer clinical and economic evaluation. This study aims to examine the financial implications of using atypical antipsychotics in a defined catchment area sample of patients with schizophrenia.
Service costs over a 10-month period were compared between groups of patients fulfilling DSM-IV criteria for schizophrenia who were taking different atypical antipsychotic agents.
All patients studied were taking clozapine (N = 31). risperidone (N = 19), or olanzapine (N = 41). Clozapine was used in more chronic patients, while risperidone and olanzapine were prescribed in both chronic and recently diagnosed cases. After background group differences were controlled for, patients on risperidone treatment incurred the lowest costs. The monthly costs for the clozapine and olanzapine groups were higher than for risperidone by US $246 and US $566, respectively.
Clozapine was reserved for more severe forms of schizophrenia, but its cost impact was relatively low. Risperidone, as prescribed in ordinary practice, may be more cost-effective than olanzapine.
非典型抗精神病药物高昂的购置成本促使人们对其进行更深入的临床和经济学评估。本研究旨在考察在特定集水区的精神分裂症患者样本中使用非典型抗精神病药物的财务影响。
比较了符合DSM-IV精神分裂症标准且服用不同非典型抗精神病药物的患者组在10个月期间的服务成本。
所有研究患者均服用氯氮平（N = 31）、利培酮（N = 19）或奥氮平（N = 41）。氯氮平用于更多的慢性患者，而利培酮和奥氮平则用于慢性和近期诊断的病例。在控制了背景组差异后，接受利培酮治疗的患者成本最低。氯氮平组和奥氮平组的每月成本分别比利培酮组高246美元和566美元。
氯氮平用于更严重的精神分裂症形式，但其成本影响相对较低。在常规治疗中使用的利培酮可能比奥氮平更具成本效益。
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