Liu Gordon G, Sun Shawn X, Christensen Dale B, Luo Xuemei
Division of Pharmaceutical Policy and Evaluative Sciences, University of North Carolina, Chapel Hill, NC 27599, USA.
Ann Pharmacother. 2004 Jan;38(1):134-41. doi: 10.1345/aph.1C485.
To review the literature on the healthcare costs associated with olanzapine and risperidone in treating schizophrenia.
Published English-language pharmacoeconomic studies on olanzapine and risperidone obtained through a MEDLINE search (1990-May 2003) were selected. Additional studies were identified from a manual search of the references of retrieved articles. data extraction: Based on the identified studies, data were extracted on various treatment costs associated with the use of antipsychotic drugs, concomitant drugs from other classes, inpatient care, outpatient care, and emergency care. Emphasis was placed on studies directly comparing olanzapine and risperidone.
Both olanzapine and risperidone were generally associated with a trend of decrease in total medical costs compared with typical antipsychotics. When directly comparing the drugs, some studies found significant cost savings in favor of olanzapine and some suggested risperidone to save total costs. Still others showed no significant difference in total costs between the 2 drug regimens.
While both olanzapine and risperidone appear to be more cost saving than typical antipsychotics, the literature offers no conclusive evidence to determine the comparative advantage of one versus another in terms of total cost outcomes. Major factors that contribute to the inconclusive findings may include across-study variations in populations, design, outcome measures, dosage, severity of illness, inclusion criteria, and statistical methodologies.
回顾有关奥氮平和利培酮治疗精神分裂症的医疗费用的文献。
通过医学文献数据库检索（1990年至2003年5月）获得的已发表的关于奥氮平和利培酮的英文药物经济学研究被选中。通过人工检索检索到的文章的参考文献确定了其他研究。数据提取：根据已确定的研究，提取了与使用抗精神病药物、其他类别的伴随药物、住院护理、门诊护理和急诊护理相关的各种治疗费用的数据。重点是直接比较奥氮平和利培酮的研究。
与典型抗精神病药物相比，奥氮平和利培酮通常都与总医疗费用下降的趋势相关。在直接比较这两种药物时，一些研究发现奥氮平在成本节约方面有显著优势，一些研究则表明利培酮能节省总成本。还有其他研究表明两种药物治疗方案的总成本没有显著差异。
虽然奥氮平和利培酮似乎都比典型抗精神病药物更节省成本，但文献中没有确凿证据来确定在总成本结果方面一种药物相对于另一种药物的比较优势。导致结果不确定的主要因素可能包括不同研究在人群、设计、结果测量、剂量、疾病严重程度、纳入标准和统计方法等方面的差异。
