Harangozó Judit, Slezák Adrienn, Borsos Kinga, Németh Orsolya, Csukly Gábor
Semmelweis Egyetem, Pszichiatriai es Pszichoterapias Klinika, Budapest, Hungary. 1089, Budapest, Kalvaria ter 5.
Psychiatr Hung. 2008;23(6):464-71.
In our present research we have studied the costs associated with switching schizophrenia patients to amisulpride as well as the efficacy of amisulpride treatment. We wanted to explore whether the relatively higher costs of amisulpride can be recovered under the current Hungarian economic and financing conditions.
From 2002, we analysed clinical improvement with a 6 months follow-up measured by CGI and also compared the costs that were incurred before and after switching in 76 patients suffering from schizophrenia who received amisulpride instead of their previous treatment with typical or atypical antipsychotics. In a second, retrospective phase of the study which lasted for 6 months, we studied the willingness of investigators and patients to continue amisulpride treatment. During this period of treatment both the investigators and the patients were unaware of the fact that the circumstances of treatment would be investigated later; thus, we could determine the number of investigators and patients who decided on the continuation of amisulpride in this phase, and how costs changed later on. In our analysis we followed the cost evaluation methodology introduced earlier by Agnes Rupp.
68 patients were available for the second phase of the study, 65 continued the treatment with amisulpride. Amisulpride has demonstrated cost neutrality in both phases of the study. Higher costs of this medicine have been compensated by an increase in productivity and the resulting cost reduction. Amisulpride treatment was associated with a significant improvement of CGI-measures.
In an open, non-controlled study, modelling a field study in its second phase, amisulpride has been shown to be an effective antipsychotic which is readily accepted by patients and clinicians and which can be prescribed without increasing costs.
在我们目前的研究中，我们研究了将精神分裂症患者换用氨磺必利的相关成本以及氨磺必利治疗的疗效。我们想探讨在当前匈牙利的经济和融资条件下，氨磺必利相对较高的成本是否能够得到弥补。
从2002年起，我们对76例接受氨磺必利而非之前使用的典型或非典型抗精神病药物治疗的精神分裂症患者进行了为期6个月的随访，通过临床总体印象量表（CGI）分析临床改善情况，并比较换药前后产生的成本。在该研究为期6个月的第二个回顾性阶段，我们研究了研究者和患者继续使用氨磺必利治疗的意愿。在这个治疗期间，研究者和患者都不知道治疗情况稍后会被调查；因此，我们可以确定在这个阶段决定继续使用氨磺必利的研究者和患者数量，以及之后成本是如何变化的。在我们的分析中，我们遵循了阿格涅丝·鲁普之前介绍的成本评估方法。
68例患者可用于研究的第二阶段，65例继续使用氨磺必利治疗。氨磺必利在研究的两个阶段均显示出成本中性。这种药物较高的成本已通过生产力的提高和由此带来的成本降低得到补偿。氨磺必利治疗与CGI测量的显著改善相关。
在一项开放、非对照研究中，该研究在第二阶段模拟了现场研究，结果表明氨磺必利是一种有效的抗精神病药物，患者和临床医生很容易接受，并且在不增加成本的情况下即可开具处方。
