Cost analysis of the treatment of schizophrenia in the UK. A simulation model comparing olanzapine, risperidone and haloperidol.
OBJECTIVE
To compare the costs of 2 atypical drug therapies (olanzapine and risperidone) with one another and with a conventional antipsychotic (haloperidol) in the treatment of schizophrenia.


METHODS
The analysis is based on a simulation model with parameter values taken mainly from clinical trial data in patients with schizophrenia, and was conducted within a UK context.


RESULTS
The 3 therapies are approximately cost neutral over a 5-year period (olanzapine 35,701 Pounds, risperidone 36,590 Pounds and haloperidol 36,653 Pounds). There is evidence of greater efficacy with the atypical drugs [average percentage of 5 years with Brief Psychiatric Rating Scale (BPRS) scores < 18: olanzapine 63.6%, risperidone 63.0% and haloperidol 52.2%]. The cost and efficacy differences between the 2 atypical drugs are too small to rank them in terms of cost effectiveness. Extensive sensitivity analysis does not change any of the main conclusions.


CONCLUSIONS
Given evidence of efficacy gains to the atypical drugs, these represent cost-effective treatment options. Prospective data from nontrial treatment settings would help substantiate the model findings.
Almond
S
S
Personal Social Services Research Unit, University of Kent at Canterbury, England.
O'Donnell
O
O
D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D001569:Benzodiazepines; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D006220:Haloperidol / Q000191:economics* / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000191:economics* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*; D006113:United Kingdom
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine