Atypical antipsychotic therapy for treatment of schizophrenia in Hong Kong Chinese patients--a cost analysis.
OBJECTIVE
To evaluate the direct medical cost of atypical antipsychotic therapy for schizophrenia among Hong Kong Chinese patients and to identify factors affecting the cost of treatment.


METHODS
In this retrospective database analysis, patient data were retrieved from three Hong Kong public hospitals. Patients aged 2 18 years who received an initial prescription for olanzapine, risperidone, quetiapine or amisulpride between April 1 and September 30, 2003; and had an ICD-10-coded diagnosis of schizophrenia were included. Patient data were collected for a maximum duration of 1 year before and after treatment initiation. Primary outcome measures were the schizophrenia-related direct medical costs. Demographic and clinical factors were analyzed by multiple regression analysis to identify influential factors for the cost of atypical antipsychotic therapy.


RESULTS
A total of 325 patient records were reviewed and 82 patients were included in the analysis. Cost per patient per month for clinic visits (US$ 67 +/- 41 versus US$ 78 +/- 41), medications (US$ 8 +/- 12 versus US$ 97 +/- 83), and the total cost per patient per month (US$ 314 +/- 898 versus US$ 431 +/- 914) increased significantly after treatment initiation (US$ 1 = HK$ 7.8). Previous duration of hospitalization (RR = 1.00, 95% CI = 1.00 1.01), history of substance abuse (RR = 1.26, 95% CI = 1.05 1.52) and use of depot antipsychotics (RR = 1.22, 95% CI = 1.05 - 1.42) were associated with higher cost of atypical antipsychotic therapy.


CONCLUSIONS
The total direct medical cost increased significantly after initiation of atypical antipsychotic therapy in a cohort of Chinese patients with schizophrenia. History of drug abuse, use of depot antipsychotics and prior duration of hospitalization were positive predictors of cost of therapy.
Law
W L
WL
Hospital Authority, Hong Kong SAR.
Hui
H Y
HY
Young
W M
WM
You
J H S
JH
D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D002681:China; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D005260:Female; D017048:Health Care Costs; D006723:Hong Kong; D006760:Hospitalization; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D012044:Regression Analysis; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics; D019966:Substance-Related Disorders / Q000150:complications; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D013469:Sulpiride; D000077582:Amisulpride; D018967:Risperidone; D000077152:Olanzapine