Souêtre E, Martin P, Lecanu J P, Alexandre L, Lozet H, Gauthier J M, Camus C
Service de Pharmacologie Clinique, Université Descartes, CHU Necker, Paris.
Encephale. 1992 May-Jun;18(3):263-9.
The aim of this study is to assess the economic impact of neuroleptic strategies in the long-term treatment of schizophrenic patients. In this respect a new neuroleptic strategy (amisulpride) was compared to a reference drug (haloperidol) using a cost minimization method. Clinical, demographic and economic (direct medical costs) data were obtained retrospectively from patients' charts. Patients (n = 160) were randomly selected according to diagnosis (schizophrenia, DSM III-R), treatment (outpatient, amisulpride or haloperidol) and follow up period (at least 6 months). The health insurance point of view was selected for the economic analysis. We found a significant reduction of the annual number of days of relapse when patients were treated with amisulpride compared to haloperidol. This reduction was associated with a significant reduction of direct costs mainly related to shorter length of hospitalization. This result was only partly explained by demographic and clinical variables such as the severity of the disease. The differences remained significant when populations were matched. This finding illustrates the validity of the concept of efficiency in psychiatry.
本研究旨在评估抗精神病药物治疗策略在精神分裂症患者长期治疗中的经济影响。在这方面，使用成本最小化方法将一种新的抗精神病药物治疗策略（氨磺必利）与一种对照药物（氟哌啶醇）进行了比较。临床、人口统计学和经济（直接医疗成本）数据是从患者病历中回顾性获取的。根据诊断（精神分裂症，DSM III - R）、治疗（门诊，氨磺必利或氟哌啶醇）和随访期（至少6个月）随机选择患者（n = 160）。经济分析选择了医疗保险的视角。我们发现，与氟哌啶醇治疗的患者相比，使用氨磺必利治疗的患者每年的复发天数显著减少。这种减少与主要因住院时间缩短而导致的直接成本显著降低相关。这一结果仅部分由人口统计学和临床变量（如疾病严重程度）所解释。当人群匹配时，差异仍然显著。这一发现说明了精神病学中效率概念的有效性。
