Health status and health care costs for publicly funded patients with schizophrenia started on clozapine.
OBJECTIVE
The study examined the effect of clozapine treatment on the health care costs and health status of people with schizophrenia who are supported by public funds.


METHODS
Thirty-three patients with schizophrenia hospitalized in a state facility were interviewed within one week of starting clozapine and six months later. Health status was assessed with four clinical rating scales measuring severity of psychopathology, negative symptoms, depression, and quality of life. Cost and health care utilization data were collected for the six months before and after initiation of clozapine.


RESULTS
Only 52 percent of the subjects stayed on clozapine for six months. Subjects who continued on clozapine were more likely to be discharged within six months than those who did not continue. Six months after clozapine was started, health care costs showed a sayings of $11,464 per person, even after adjustment for pretreatment costs, and health status was improved.


CONCLUSIONS
For subjects who continued on clozapine for six months, clozapine treatment was associated with reduced days of psychiatric hospital care, reduced overall costs despite increased outpatient treatment and residential costs, and improved health status.
Blieden
N
N
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI 48201, USA.
Flinders
S
S
Hawkins
K
K
Reid
M
M
Alphs
L D
LD
Arfken
C L
CL
D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use; D003024:Clozapine / Q000191:economics* / Q000627:therapeutic use; D017046:Cost Savings / Q000706:statistics & numerical data; D005260:Female; D005380:Financing, Government / Q000191:economics*; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy / Q000191:economics*
D014150:Antipsychotic Agents; D003024:Clozapine