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Titolo:
Olanzapine versus risperidone - A prospective comparison of clinical and economic outcomes in schizophrenia
Autore:
Edgell, ET; Andersen, SW; Johnstone, BM; Dulisse, B; Revicki, D; Breier, A;
Indirizzi:
Eli Lilly & Co, Indianapolis, IN 46285 USA Eli Lilly & Co Indianapolis INUSA 46285 & Co, Indianapolis, IN 46285 USA MEDTAP Int, Bethesda, MD USA MEDTAP Int Bethesda MD USAMEDTAP Int, Bethesda, MD USA
Titolo Testata:
PHARMACOECONOMICS
fascicolo: 6, volume: 18, anno: 2000,
pagine: 567 - 579
SICI:
1170-7690(200012)18:6<567:OVR-AP>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
ATYPICAL ANTIPSYCHOTIC-DRUGS; CARE RESOURCE UTILIZATION; PSYCHOTIC DISORDERS; COST-EFFECTIVENESS; REFRACTORY SCHIZOPHRENIA; PHARMACOECONOMIC EVALUATION; RESISTANT SCHIZOPHRENIA; HALOPERIDOL; CLOZAPINE; THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
82
Recensione:
Indirizzi per estratti:
Indirizzo: Edgell, ET Eli Lilly & Co, Lilly Res Ctr Ltd, European Hlth Outcomes Res, Erl Wood Manor, Windlesham GU20 6PH, Surrey, England Eli Lilly & Co Erl Wood Manor Windlesham Surrey England GU20 6PH
Citazione:
E.T. Edgell et al., "Olanzapine versus risperidone - A prospective comparison of clinical and economic outcomes in schizophrenia", PHARMACOECO, 18(6), 2000, pp. 567-579

Abstract

Objective: To compare the clinical and economic outcomes associated with olanzapine and risperidone treatment for schizophrenia. Design and setting: An international, multicentre, double-blind, prospective study. To facilitate economic comparisons, our sample was restricted to patients enrolled in US sites. 150 patients with a Diagnostic and Statistical Manual of mental disorders, 4th edition (DSM-IV) diagnosis of schizophrenia, schizoaffective disorder or schizophreniform disorder were randomised to therapy with either olanzapine 10 to 20 mg/day (n = 75) or risperidone 4to 12 mg/day (n = 75) for a maximum of 28 weeks. In addition to tolerability and efficacy assessments, use of health services was assessed at baseline and prospectively, at 8-week intervals and at study completion. Clinically important response, defined as a 40% improvement in the Positive and Negative Syndrome Scale total score, maintenance of response and rates of treatment-emergent extrapyramidal symptoms were compared between groups. Direct medical costs were estimated by assigning standardised prices to resource units. Median total, inpatient/outpatient service and medication acquisitioncosts were compared between treatment groups. Main outcome measures and results: The mean modal dosages for the olanzapine and risperidone treatment groups were 17.7 +/- 3.4 mg/day and 7.9 +/- 3.2 mg/day, respectively. Olanzapine-treated patients were more likely to maintain response compared with risperidone-treated patients (p = 0.048). In addition, a smaller proportion of olanzapine-treated patients required anticholinergic therapy compared with risperidone-treated patients (25.3 vs 45.3%; p = 0.016). Total per patient medical costs over the study interval were$US2843 (1997 values) [36%] lower in the olanzapine treatment group than in the risperidone treatment group (p = 0.342). Medication costs were significantly higher for olanzapine-treated patients ($US2513 vs $US1581; p < 0.001), but this difference was offset by a reduction of $US3774 (52%) in inpatient/outpatient service costs for olanzapine-treated patients in comparison with risperidone-treated patients ($US3516 vs $US7291, p = 0.083). Mediancost findings were consistent with results observed using other robust measures of central tendency and provide conservative estimates of potential savings that may be obtained from olanzapine therapy. Conclusions: In this study, olanzapine-treated patients experienced clinical improvements that translated into savings in costs of care for both inpatient and outpatient services. These savings offset the difference in medication acquisition cost between olanzapine and risperidone.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 09:50:58