title: Clinical equivalence of generic clozapine.
abstract: OBJECTIVE
  To determine if mental health service utilization increases when patients are converted to generic clozapine.
  
  
  METHODS
  About 125 patients taking clozapine in a community mental health clinic were switched from Novartis Clozaril to generic clozapine (Mylan Pharmaceuticals). Serum clozapine levels were obtained 2 weeks before, and 2 weeks after, the switch to generic clozapine. The number of outpatient visits, emergency room visits, and hospitalizations in the year prior to the switch were compared to those in the year following the switch, to determine service utilization.
  
  
  RESULTS
  Psychiatric emergency room visits decreased, but clozapine serum levels, inpatient hospital days, partial hospital admissions, and outpatient psychiatrist visits did not change after the switch to generic clozapine.
  
  
  CONCLUSIONS
  There were no significant increases in mental health service utilization after the conversion to Mylan generic clozapine. The switch to Mylan generic clozapine was cost effective, as the reduction in pharmacy costs was not offset by increased utilization costs.
authors.affiliation: Department of Psychiatry, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0020, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Healy
authors.forename: Stephan
authors.initials: S
authors.lastname: Taylor
authors.forename: Mona
authors.initials: M
authors.lastname: Goldman
authors.forename: Kris
authors.initials: K
authors.lastname: Barry
authors.forename: Frederic
authors.initials: F
authors.lastname: Blow
authors.forename: Karen K
authors.initials: KK
authors.lastname: Milner
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D003024:Clozapine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000188:drug therapy*; D013810:Therapeutic Equivalency
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine