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Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy

  • Linda M. Davies (a1), Shôn Lewis (a1), Peter B. Jones (a2), Thomas R. E. Barnes (a3), Fiona Gaughran (a4), Karen Hayhurst (a1), Alison Markwick (a1) and Helen Lloyd (a5)...

Abstract

Background

There are claims that the extra costs of atypical (second-generation) antipsychotic drugs over conventional (first-generation) drugs are offset by improved health-related quality of life.

Aims

To determine the relative costs and value of treatment with conventional or atypical antipsychotics in people with schizophrenia.

Method

Cost-effectiveness acceptability analysis integrated clinical and economic randomised controlled trial data of conventional and atypical antipsychotics in routine practice.

Results

Conventional antipsychotics had lower costs and higher quality-adjusted life-years (QALYs) than atypical antipsychotics and were more than 50% likely to be cost-effective.

Conclusions

The primary and sensitivity analyses indicated that conventional antipsychotics may be cost-saving and associated with a gain in QALYs compared with atypical antipsychotics.

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Copyright

Corresponding author

Linda Davies, Division of Psychiatry, University of Manchester, Rawnsley Building, MRI, Oxford Road, Manchester M13 9WL, UK. Tel: +44(0) 161 276 5380; email: Linda.davies@manchester.ac.uk

Footnotes

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Declaration of interest

Funding from the Secretary of State for Health (UK). The authors have received consultancy fees, honoraria or departmental support from the pharmaceutical industry, including Novartis, BMS Otsuka, Janssen Cilag, Servier, BMS, Astra-Zeneca, Sanofi-Synthelabo, Eli Lilly and Johnson & Johnson. F.G. is relatedto an employee of Eli Lilly & Co.

Footnotes

References

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Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy

  • Linda M. Davies (a1), Shôn Lewis (a1), Peter B. Jones (a2), Thomas R. E. Barnes (a3), Fiona Gaughran (a4), Karen Hayhurst (a1), Alison Markwick (a1) and Helen Lloyd (a5)...

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Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy

  • Linda M. Davies (a1), Shôn Lewis (a1), Peter B. Jones (a2), Thomas R. E. Barnes (a3), Fiona Gaughran (a4), Karen Hayhurst (a1), Alison Markwick (a1) and Helen Lloyd (a5)...
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eLetters

Terminology - Cost effectiveness or Cost Utility analysis

Rajeev Krishnadas, SHO - Psychiatry
15 August 2007

Dear Editor,

I read with interest the article titled "Cost-effectiveness of first-v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy" [1]. First of all I would like to congratulate the authors on the great efforts put into the study.

The authors have used the term "Cost Effectiveness" throughout the paper. Although they have taken into consideration a single outcome/effectmeasure for calculating the ICER, the measure being "QALY", the term "CostUtility" may have been more appropriate for the paper.[2] (The acronym CUtLASS for cost utility.)

An earlier paper by the same authors using ratings on QLS (not QALY) and PANSS as outcome measures calls it "Cost Utility" instead of "Cost Effectiveness" analysis.[3]

Although the principles behind a cost effectiveness and cost utility analysis remain the same and the duration of this study is one year, usingthe terms interchangeably may lead to confusion and difficulties in comparing data in the future. [2]

1. Davies LM, Lewis S, Jones PB, Barnes TR, Gaughran F, Hayhurst K, Markwick A, Lloyd H. Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy Br J Psychiatry. 2007 Jul;191:14-22.

2. Hoch JS, Dewa CS. An Introduction to Economic Evaluation: What’s in a Name? Can J Psychiatry 2005;50:159–166

3. Jones, P. B., Davies, L. M., Barnes, T. R. E., et al (2006) Randomized controlled trial of effect on quality of life of second generation versus first generation antipsychotic drugs in schizophrenia. Arch Gen Psychiatry, 63, 1079 -1087
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Conflict of interest: None Declared

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