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Titolo:
Risperidone, haloperidol and clozapine in the South Carolina Medicaid program - A comparative analysis of utilisation and expenditure
Autore:
Shermock, KM; Sadik, MK; Kozma, CM; Sesti, AM; Reeder, CE;
Indirizzi:
Cleveland Clin Fdn, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 in Fdn, Cleveland, OH 44195 USA Janssen Pharmaceut, Outcomes Res Dept, Titusville, NJ USA Janssen Pharmaceut Titusville NJ USA tcomes Res Dept, Titusville, NJ USA Strateg Outcomes Serv CareSci, Res Triangle Pk, NC USA Strateg Outcomes Serv CareSci Res Triangle Pk NC USA Triangle Pk, NC USA Warner Lambert Parke Davis, Parke Davis Pharmaceut Res, Outcomes Dept, AnnArbor, MI 48105 USA Warner Lambert Parke Davis Ann Arbor MI USA 48105 AnnArbor, MI 48105 USA Univ S Carolina, Coll Pharm, Columbia, SC 29208 USA Univ S Carolina Columbia SC USA 29208 Coll Pharm, Columbia, SC 29208 USA
Titolo Testata:
DISEASE MANAGEMENT & HEALTH OUTCOMES
fascicolo: 4, volume: 9, anno: 2001,
pagine: 203 - 213
SICI:
1173-8790(2001)9:4<203:RHACIT>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC-SCHIZOPHRENIC PATIENTS; 1ST-EPISODE SCHIZOPHRENIA; MANAGEMENT; PLACEBO; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Shermock, KM Cleveland Clin Fdn, 9500 Euclid Ave,Desk QQb32, Cleveland, OH44195 USA Cleveland Clin Fdn 9500 Euclid Ave,Desk QQb32 Cleveland OH USA 44195
Citazione:
K.M. Shermock et al., "Risperidone, haloperidol and clozapine in the South Carolina Medicaid program - A comparative analysis of utilisation and expenditure", DIS MANAG H, 9(4), 2001, pp. 203-213

Abstract

Objective: To determine whether the increased acquisition costs associatedwith the atypical antipsychotic risperidone are offset by reductions in other mental health care utilisation and expenditure. Design and setting: The study was population-based and used South CarolinaMedicaid claims data to determine changes in mental healthcare utilisationand expenditures related to schizophrenia. Changes in mental health-related utilisation and expenditures over time were calculated; total mental health-related expenditures and utilisation were disaggregated into pharmaceuticals, inpatient hospitalisations, and ambulatory and inpatient physician services [Health Care Financing Administration (HCFA) 1500 claims]. Groups ofpatients were compared for two 6-month periods preceding the initial prescription (pre1 and pre2), and two 6-month periods following the initial prescription (post1 and post2). Costs were discounted to the index date. Perspective: Payor (South Carolina Medicaid). Patients: Those patients with schizophrenia who received initial prescriptions for risperidone (n = 862), haloperidol (n = 325) or clozapine (n = 66)between February 1994 and June 1995 tinder date). Main outcome measures and results: The mean increase in level of expenditure per person for pharmaceuticals from the pre- to the post-treatment period was significantly greater in the risperidone [751 US dollars ($US)I and clozapine ($US1423) groups than in the haloperidol group ($US6). However, the change in mean level of total mental healthcare expenditure per person was not significantly different fur the risperidone group ($US832) compared with the haloperidol group ($US540) over the same time period, but the increase in the clozapine group was significantly higher ($US2500.23; p < 0.0001for clozapine vs risperidone and clozapine vs haloperidol). As the difference between the risperidone and haloperidol groups in pharmaceutical expenditures was not reflected in total mental healthcare expenditures, the remaining component costs were investigated to identify where thedifference was offset. Compared with haloperidol, risperidone had a significantly smaller change in per person mean level of ambulatory and inpatientphysician services claims for expenditure ($US692 vs $US269, p = 0.01) andutilisation (+1.70 vs -0.21, p < 0.0001). Conclusions: Based on these findings, we conclude that, in this populationof patients with schizophrenia increased costs associated with risperidonewere offset by decreases in other mental healthcare utilization. Risperidone is a technical substitute for ambulatory healthcare services.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/11/19 alle ore 03:13:10