Aitchison K J, Kerwin R W
Section of Clinical Neuropharmacology, Institute of Psychiatry, London.
Br J Psychiatry. 1997 Aug;171:125-30. doi: 10.1192/bjp.171.2.125.
Schizophrenia is highly expensive in calculable and incalculable costs. Measures which impact the cost in the most severely affected are likely to produce the greatest cost reductions. Studies regarding clozapine in the USA have demonstrated clear cost-effectiveness, despite the high prescription costs. There are no prior UK studies.
We performed a cost-effectiveness analysis comparing the three years prior to commencing clozapine to the period following establishment of clozapine treatment (mean 36.4 months) for 26 patients with chronic schizophrenia or schizoaffective disorder.
There was a significant improvement in all clinical ratings applied (and a mean net saving of ponds 3768 per annum). The cost-effectiveness of clozapine was double that of conventional neuroleptics (15.2 pre-, 33.0 post-clozapine, P < 0.005).
As a naturalistic study our data provide valuable information on the cost-effectiveness of clozapine in the UK. Our methodology could be applied in a community setting or in the study of another atypical neuroleptic.
精神分裂症在可计算和不可计算的成本方面都非常高昂。对受影响最严重的成本产生影响的措施可能会带来最大程度的成本降低。在美国，有关氯氮平的研究已证明其具有明确的成本效益，尽管其处方成本很高。此前尚无英国的相关研究。
我们对26例慢性精神分裂症或分裂情感性障碍患者进行了成本效益分析，比较了开始使用氯氮平前三年与氯氮平治疗确立后时期（平均36.4个月）的情况。
所有应用的临床评分均有显著改善（每年平均净节省3768英镑）。氯氮平的成本效益是传统抗精神病药物的两倍（氯氮平治疗前为15.2，治疗后为33.0，P<0.005）。
作为一项自然主义研究，我们的数据提供了有关氯氮平在英国成本效益的宝贵信息。我们的方法可应用于社区环境或另一非典型抗精神病药物的研究。
