Modelling the impact of clozapine on suicide in patients with treatment-resistant schizophrenia in the UK.
BACKGROUND
Schizophrenia is a major cause of suicide, and symptoms characteristic of treatment-resistant disease are strong risk factors. Clozapine reduces symptoms in 60% of such patients and significantly decreases the risk of suicide.


OBJECTIVE
To model the impact of increased clozapine prescribing on lives saved and resource utilisation.


METHODS
A model was built to compare current levels of clozapine prescribing with a scenario in which all suitable patients with treatment-resistant schizophrenia received clozapine.


RESULTS
It was estimated that an average of 53 lives could be saved in the UK each year. If clozapine is cost-neutral, the cost per life-year saved is pound 5108. If clozapine achieves a 10% reduction in annual support costs, the net saving is pound 8.7 million per annum. An average of 167 acute beds would be freed each year.


CONCLUSIONS
The use of clozapine in treatment-resistant schizophrenia saves lives, frees resources and is cost-effective.
Duggan
Andy
A
Abacus International, Bicester, UK.
Warner
Juliet
J
Knapp
Martin
M
Kerwin
Robert
R
D014150:Antipsychotic Agents / Q000191:economics / Q000627:therapeutic use*; D003024:Clozapine / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods; D006295:Health Resources / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015993:Life Tables; D015233:Models, Statistical; D015995:Prevalence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D013405:Suicide / Q000191:economics; D006113:United Kingdom / Q000453:epidemiology; D000092864:Suicide Prevention
D014150:Antipsychotic Agents; D003024:Clozapine