title: The cost-effectiveness of clozapine: a controlled, population-based, mirror-image study.
abstract: A retrospective cohort study, with a mirror-image design, was used to measure inpatient service utilization in 63 consecutive patients started on clozapine from a geographical catchment area compared to a control group matched for previous inpatient service use. An intent-to-treat analysis, including those patients (n = 28) who discontinued clozapine during the study period, showed a significant reduction in number of admissions and total time spent in hospital in the 2 years following clozapine initiation compared to the previous 2 years and to the follow-up period in the control group. This translated into a reduction of 7,300 pounds in hospitalization costs per patient started on clozapine, over the 2-year period. In those patients who continued clozapine treatment for the whole of the 2-year period, there was a two-thirds reduction in number of admissions and total time spent in hospital compared to no change in the clozapine discontinuers. These findings suggest that clozapine is a clinically and cost-effective intervention for severe schizophrenia in routine clinical settings.
authors.affiliation: School of Psychiatry and Behavioural Sciences, University of Manchester, Wythenshawe Hospital, UK. khayhurst@fs1.with.man.ac.uk
authors.forename: K P
authors.initials: KP
authors.lastname: Hayhurst
authors.forename: P
authors.initials: P
authors.lastname: Brown
authors.forename: S W
authors.initials: SW
authors.lastname: Lewis
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D003024:Clozapine / Q000191:economics* / Q000627:therapeutic use*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004739:England; D005260:Female; D006282:Health Personnel / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine