Requiring people with schizophrenia to first fail on an older, inexpensive generic antipsychotic before allowing them to switch to the newer antipsychotic Zyprexa® (olanzapine) may not result in cost savings overall, according to a new study published in this month’s issue of Value in Health.

The data showed that despite higher medication costs of Zyprexa, the difference in one-year direct total costs between Zyprexa, as initial (first-line) treatment, and conventional antipsychotics as first line treatment, was small and not statistically significant.

Findings indicate that any savings on medication costs were offset by the increased costs of other services associated with treatment with conventional antipsychotics including hospitalizations, crisis interventions and emergency room visits.

Researchers in this study also compared the cost-effectiveness of Zyprexa (mean modal dose 13.49 mg/day) and Risperdal® (risperidone) (mean modal dose 4.95 mg/day) as first-line treatment for schizophrenia and found the total costs associated with the two medications to be similar and not significantly different from each other.

This cost-effectiveness study was designed specifically to compare the clinical and social effectiveness and total direct costs of treatment with different antipsychotics, to help inform private and public payer systems’ practices and policies regarding first-line antipsychotic options for treating schizophrenia.

“These data showed that regardless of whether a person was initiated on a conventional or atypical antipsychotic, the overall direct costs of treating a person with schizophrenia for one year were essentially the same,” said Ralph Aquila, M.D., one of twenty-one study investigators who is the director of residential community services at St. Luke’s/Roosevelt Hospital Center. “This study suggests that cost cutting efforts that require patients with schizophrenia to first fail on older, conventional antipsychotics before providing access to newer medications like Zyprexa, do not necessarily result in overall cost savings and may unnecessarily restrict access to the most optimal treatment for patients.”

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 7 Jan 2006
    Published on PsychCentral.com. All rights reserved.