Cost-effectiveness of Clozapine in patients with high and low levels of hospital use.
This study examined the relationship between pretreatment hospital use and the cost-effectiveness of clozapine in the treatment of refractory schizophrenia.
Data from a 15-site randomized clinical trial were used to compare clozapine with haloperidol in hospitalized Veterans Affairs patients with refractory schizophrenia (n=423).
Outcomes were compared among those with many days in the hospital use (hereafter, high hospital users) (n=141 ; mean=215 psychiatric hospital days in the year prior to study entry) and those with few days in the hospital use (hereafter, low hospital users) (n=282 ; mean=58 hospital days).
Analyses were conducted with the full intention-to-treat sample (n=423) and with crossovers excluded (n=291).
Clozapine treatment resulted in greater reduction in hospital use among high hospital users (35 days less than controls, P=02) than among low users (21 days less than controls, P=05).
Patients taking clozapine also had lower health care costs ; after including the costs of both medications and other health services, costs were $7134 less than for controls among high hospital users (P=14) but only $759 less than for controls among low hospital users (P=82).
Clinical improvement in the domains of symptoms, quality of life, extrapyramidal symptoms, and a synthetic measure of multiple outcomes favored clozapine in both high and low hospital user groups. (...)
Mots-clés Pascal : Schizophrénie, Chimiothérapie, Efficacité traitement, Clozapine, Neuroleptique, Atypique, Psychotrope, Analyse coût efficacité, Hospitalisation, Economie santé, Homme, Psychose, Dibenzodiazépine
Mots-clés Pascal anglais : Schizophrenia, Chemotherapy, Treatment efficiency, Clozapine, Neuroleptic, Atypical, Psychotropic, Cost efficiency analysis, Hospitalization, Health economy, Human, Psychosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0339330
Code Inist : 002B02B03. Création : 14/12/1999.