Atypical antipsychotic monotherapy for schizophrenia: clinical review and economic evaluation of first year of treatment
Farahati F, Boucher M, Moulton K, Williams R, Herrmann N, Silverman M, Skidmore B
Record ID 32007000542
English
Authors' objectives:
"The aim of this analysis is to evaluate the clinical effectiveness of the four AAPs that are commercially available in Canada (risperidone, olanzapine, quetiapine, and clozapine), and to evaluate the economic implications of each when used for the maintenance treatment of schizophrenia and related psychoses (including schizophreniform, delusional, and schizoaffective disorders)." (executive summary)
Authors' recommendations:
Implications for Decision Making
Differences exist among atypical antipsychotics. The available evidence suggests that, compared with risperidone, olanzapine is associated with a lower risk of relapse and of treatment discontinuation, but is less well tolerated. Evidence also shows that clozapine use reduces suicide risk in high-risk patients, compared with olanzapine.
Costs to the health care system do not reflect differences in utilization costs. Generic and brand-name olanzapine will require a larger investment by drug plans than quetiapine and risperidone. These costs are offset by reduced downstream costs from hospitalization, the largest cost component for treating patients with schizophrenia.
Decisions should be revisited. The lack of high-quality evidence to inform first-line therapy reimbursement decisions suggests that additional analysis should be undertaken when comparative effectiveness studies are available. The costs associated with polytherapy, long-term treatment, and the role of traditional antipsychotics should be considered.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Cost-Benefit Analysis
- Antipsychotic Agents
- Schizophrenia
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health (CADTH)
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