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  • Print publication year: 2010
  • Online publication date: May 2010

Chapter 11 - Substance use in persons with schizophrenia: incidence, baseline correlates, and effects on outcome


In the United States, second-generation antipsychotics have become the most widely used drugs in the treatment of schizophrenia, with total annual costs of over $12 billion. While the main CATIE analysis showed that patients stayed on olanzapine longer than two other second-generation antipsychotics, none of four second-generation antipsychotics, showed any advantage over the first-generation antipsychotic perphenazine on measures of symptoms. The cost-benefit analysis presented here, which combines cost and benefit data in a single analysis, found perphenazine to be superior to each of the four second-generation antipsychotics with which it was compared. While cost-effectiveness analysis evaluates the health benefits per additional dollar expended using the measures of quality of life, cost-benefit analysis attempts to put monetary value on the health benefits of treatment and thus monetizes all outcomes. Antipsychotic medication costs were based on wholesale prices for the specific capsule strengths used in CATIE, adjusted downward for discounts and rebates.


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