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Titolo:
COST-EFFECTIVENESS OF CLOZAPINE MONITORING AFTER THE FIRST 6 MONTHS
Autore:
ZHANG ML; OWEN RR; POPE SK; SMITH GR;
Indirizzi:
5800 W 10TH ST,SUITE 605 LITTLE ROCK AR 72204 VET AFFAIRS MED CTR,VET AFFAIRS HLTH SERV RES & DEV FIELD PROGRAM LITTLE ROCK AR 00000 UNIV ARKANSAS MED SCI HOSP,DEPT PSYCHIAT,CTR OUTCOMES RES & EFFECTIVENESS LITTLE ROCK AR 00000 UNIV ARKANSAS MED SCI HOSP,DEPT PSYCHIAT,CTR MENTAL HLTHCARE RES LITTLE ROCK AR 00000
Titolo Testata:
Archives of general psychiatry
fascicolo: 10, volume: 53, anno: 1996,
pagine: 954 - 958
SICI:
0003-990X(1996)53:10<954:COCMAT>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROLEPTIC-RESISTANT SCHIZOPHRENIA; INDUCED AGRANULOCYTOSIS; DRUG-THERAPY; MORTALITY; QUALITY; SYSTEM; LIFE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Physical, Chemical & Earth Sciences
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
M.L. Zhang et al., "COST-EFFECTIVENESS OF CLOZAPINE MONITORING AFTER THE FIRST 6 MONTHS", Archives of general psychiatry, 53(10), 1996, pp. 954-958

Abstract

Background: Clozapine is effective in treating patients with schizophrenia who do not respond to conventional neuroleptic drugs. The drug is unique in that it is available only with a US Food and Drug Administration-mandated system for weekly monitoring of patients' white blood cell counts. No study has been conducted to evaluate the cost-effectiveness of this mandatory monitoring system. Methods: A benchmark case was established by utilizing cumulative incidence rates of agranulocytosis from a recent study with a large sample of clozapine-treated patients. We assumed a 20% mortality among patients with agranulocytosis, $30.61 in monitoring costs each week, and 14.4 years of remaining life expectancy after detection of agranulocytosis. Based on these benchmark assumptions, cost-effectiveness ratios in dollars per quality-adjusted life-year were calculated for the first, second, and third 6-month periods during which a patient was receiving clozapine. Sensitivity analyses were performed with more conservative assumptions in 5 alternative scenarios. Results: In the benchmark case, costs per quality-adjusted life-year gained were $61 694, $925 418, and $420 644 for the first, second, and third 6-month periods of clozapine treatment, respectively. In the alternative scenarios, these costs ranged from $7923 to $46 056 for the first 6-month period and from $54 025 to $690 850 for the second and third 6-month periods. Conclusions: While the costs of monitoring patients with schizophrenia in the first 6-month period of clozapine treatment seem to be justifiable, monitoring thereafter may not be cost-effective because of the very low incidence of agranulocytosis in the later periods.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 01:20:28