Comparative Effectiveness of Clozapine and Standard Antipsychotic Treatment in Adults With Schizophrenia

Stroup, T. Scott; Gerhard, Tobias; Crystal, Stephen; Huang, Cecilia; Olfson, Mark

doi:10.1176/appi.ajp.2015.15030332

Cited by 145 publications

(104 citation statements)

References 32 publications

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“…A utilização da Olanzapina no tratamento farmacológico contínuo da esquizofrenia evidencia efeitos contra as manifestações de hostilidade, sendo esse, um dos motivos de sua escolha (VOLAVKA et al, 2016). O uso da Clozapina foi correlacionado a índices reduzidos de internações psiquiátricas, suspensão da farmacoterapia (STROUP et al,2015).…”

Section: Resultsunclassified

Uso De Antipsicóticos Atípicos Em Pacientes Com Esquizofrenia

Ferreira‐Correia¹,

Vêra²,

Lucchese³

et al. 2017

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Section: Resultsunclassified

Uso De Antipsicóticos Atípicos Em Pacientes Com Esquizofrenia

Ferreira‐Correia¹,

Vêra²,

Lucchese³

et al. 2017

Enci Bio

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“…A number of underlying assumptions suggest that, if anything, benefits of increased clozapine utilization have been underestimated. In addition, much is known about the improved outcomes, adherence, and persistence rates associated with clozapine treatment (75,76). However, the study also had some limitations.…”

Section: Discussionmentioning

confidence: 99%

The Business Case for Expanded Clozapine Utilization

Gören¹,

Rose²,

Smith³

et al. 2016

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OBJECTIVE: In most settings, less than 25% of patients with treatment-resistant schizophrenia receive clozapine, the only medication proven effective for treatment-resistant schizophrenia. Therefore, a business case analysis was conducted to assess whether increasing clozapine utilization for treatment-resistant schizophrenia in a health care system would result in direct health care cost savings. METHODS: Veterans with treatment-resistant schizophrenia who were treated in the Veterans Health Administration (VHA) were studied. Treatment response, suicides, adverse drug reactions (and associated mortality), and effects on inpatient hospitalization related to clozapine were derived from a systematic review of published studies. A one-factor sensitivity analysis and a probabilistic sensitivity analysis (PSA) with Monte Carlo simulation were conducted to calculate the cost-benefits of increased clozapine utilization. RESULTS: Despite monitoring costs, in the base case analysis, the VHA would save $22,444 per veteran with treatment-resistant schizophrenia over the first year of clozapine therapy, primarily from 18.6 fewer inpatient days per patient. If current utilization was doubled, and 50% of those veterans continued clozapine treatment for one year, VHA would save an estimated $80 million. Cost savings were most sensitive to the proportion of treatment-resistant patients who received clozapine, decrease in inpatient days, cost of inpatient stays, clozapine response rate, and number of patients with treatment-resistant schizophrenia. In the PSA, initiation of clozapine for all VHA patients with treatment-resistant schizophrenia who were not currently treated with clozapine would save at least $290 million in 95% of simulations. CONCLUSIONS: Increased clozapine utilization would result in net cost savings for the VHA

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“…Naturalistic observations of outcomes in clinical practice strongly support the superiority of clozapine over other antipsychotics in terms of continuation with treatment [18], relapse [19], hospitalisations [20,21] and even mortality [22]. Clozapine may be the only antipsychotic with which relapse occurs only after periods of non-ingestion and never during full compliance [23].…”

Section: ó Springer International Publishing Switzerland 2017mentioning

confidence: 98%

Clozapine for Treatment-Resistant Schizophrenia: Still the Gold Standard?

Taylor

2017

CNS Drugs

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Comparative Effectiveness of Clozapine and Standard Antipsychotic Treatment in Adults With Schizophrenia

Cited by 145 publications

References 32 publications

Uso De Antipsicóticos Atípicos Em Pacientes Com Esquizofrenia

Uso De Antipsicóticos Atípicos Em Pacientes Com Esquizofrenia

The Business Case for Expanded Clozapine Utilization

Clozapine for Treatment-Resistant Schizophrenia: Still the Gold Standard?

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