Second-generation antipsychotics: reviewing the cost-effectiveness component of the CATIE trial.
The cost-effectiveness component of the 18-month CATIE trial of schizophrenia pharmacotherapy (n = 1460) showed that the first-generation antipsychotic perphenazine was US$300-600 per month less expensive than each of four second-generation antipsychotics, and no less effective across multiple measures. We consider whether or not each of eight potential methodological limitations could weaken this conclusion: follow-up rates, study duration, sample characteristics, the choice of outcome measures, exclusion of patients with tardive dyskinesia from assignment to perphenazine, choice of study drugs and doses, reliance on intention-to-treat analysis, and differences in prestudy treatment. We conclude that results of CATIE are robust to these limitations. Perphenazine seems to have been a more representative choice for first-generation antipsychotic comparison treatment than haloperidol.
Yale Medical School, Northeast Program Evaluation Center (182), VA Connecticut Health Care System, 950 Campbell Ave., West Haven, CT 06516, USA. robert.rosenheck@yale.edu.
Robert
R
Rosenheck
Marvin
M
Swartz
Joseph
J
McEvoy
T Scott
TS
Stroup
Sonia
S
Davis
Richard Se
RS
Keefe
John
J
Hsiao
Jeffrey
J
Lieberman