Cost-Effectiveness of Second-Generation Antipsychotics and Perphenazine in a Randomized Trial of Treatment for Chronic Schizophrenia

Rosenheck, Robert A.; Leslie, Douglas L.; Sindelar, Jody L.; Miller, Edward; Lin, Haiqun; Stroup, T. Scott; McEvoy, Joseph P.; Davis, Sonia M.; Keefe, Richard S.E.; Swartz, Marvin S.; Perkins, Diana O.; Hsiao, John K.; Lieberman, Jeffrey A.

doi:10.1176/ajp.2006.163.12.2080

Cited by 231 publications

(163 citation statements)

References 25 publications

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“…However, most of cost studies in this field often fail to link costs to outcomes of care, and they do not necessarily specify the cost of psychopharmacological drug use. In the face of recent doubts about the cost-effectiveness of second-generation antipsychotics informed by controversial findings from various trials and meta-analyses (Rosenheck, 2006;Rosenheck et al, 2006;Jones et al 2006;Davies et a.l. 2008;Zhu et al 2008;Carpenter & Buchanan 2008), quantitative data in this field are fundamental to the ongoing transformation of community care systems.…”

Section: Introductionmentioning

confidence: 99%

Cost of treatment of schizophrenia in six European countries

Salize

McCabe

Bullenkamp

et al. 2009

Schizophrenia Research

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Background and aims:As part of a RCT in six European sites, the direct mental health care cost for 422 patients with schizophrenia was analysed according to how total, and medication costs differed across sites and which variables were likely to predict total or service-specific costs.Method: Service use was recorded continuously during a 12-month follow-up. Prescribed psychotropic medication was recorded at baseline and 12 months later. Service use data were transformed into EURO, log-transformed and analysed using linear regression models. Results:Although samples were homogeneous, large inter-site cost differences were found (annual means ranging from 2,958 € in Spain up to 36,978 € in Switzerland). Psychopharmacologic costs were much more constant across sites than costs for other services. Total costs were associated more with region or socio-demographic characteristics than with disorder related parameters. Conclusions:The findings confirm remarkable differences in direct costs of patients wit schizophrenia across Europe. However, the relative stability of medication costs suggests a need to analyse mechanisms that influence service specific costs for schizophrenia.

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Section: Introductionmentioning

confidence: 99%

Cost of treatment of schizophrenia in six European countries

Salize

McCabe

Bullenkamp

et al. 2009

Schizophrenia Research

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“…It is a warning claim that 90 % of trials showed superiority of the sponsor's drug [18] what can explain "Why olanzapine beats risperidone, risperidone beats quetiapine, and quetiapine beats olanzapine" [ 19]. Several large independent studies like CATIE (Clinical Antipsychotic Trials of Intervention Eff ectiveness), CUtLASS (Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia), and EUFEST (European First Episode Study) have found that the new generation antipsychotics are no more eff ective, no better tolerated and are less cost eff ective than their old generation predecessors [20,21,22,23]. Some independent meta-analyses pooling unpublished as well as published data indicated that SSRIs were no more eff ective than placebo in treating mild-to-moderate depression [24,25].…”

Section: Volume 4 • Number 2 • May 2017 • Hophmentioning

confidence: 99%

Placebo and nocebo phenomena from the perspective of evidence based and person centered medicine

Jakovljević¹

2017

Hosp Pharm Int Multi J

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SUMMARYIntroduction: Placebo and nocebo phenomena in pharmacology are very important, but controversial issues from the perspective of evidence-based medicine (EBM) in many ways. Topic: Glorifi cation and vilifi cation of placebo controlled studies are the two opposite sides of the prevailing misunderstanding placebo and nocebo phenomena in medicine and pharmacology. This misunderstanding is an essential component of the pseudoscientifi c evaluation and evidence-based medicine. The using of placebo and avoidance of nocebo responses have been recommended as promising additional clinical strategies. The aim and purpose of this paper is to give a transdisciplinary and integrative overview of the placebo and nocebo from the perspective of person-centered medicine and also to provide some practical tips on how to increase placebo and decrease nocebo response in clinical practice. Conclusions: Confl icting data from clinical trials and misunderstanding of placebo and nocebo phenomena are essential components of the contamination and confusion regarding evidence-based medicine. Person-centered clinical pharmacology is partly about taking advantage of placebo and avoiding of nocebo phenomena in a clinical setting as additive eff ects to improve the eff ectiveness of the standard medication.

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“…While patients stayed on olanzapine longer than other medications 2 there were no significant advantages for any atypical as compared to perphenazaine on measures of symptoms, 3 neurologic side effects, 2 neurocognition, 4 quality of life, 5 employment, 6 or violent behavior. 7 Patients assigned to perphenazine were more likely to change medications due to extrapyramidal symptoms (EPS) but there was no significant difference between perphenazine and any atypical antipsychotic on the broader measure of time to discontinuation'for any adverse effect or on standard measures of neurological side effects, and the difference in discontinuation for EPS was small (8% for perpehanzine vs 4% for ziprasidone and 2% for olanzapine).…”

mentioning

confidence: 95%

Clinical Experiences and Clinical Trials

Fusar-Poli¹

2008

CNS spectr.

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Cost-Effectiveness of Second-Generation Antipsychotics and Perphenazine in a Randomized Trial of Treatment for Chronic Schizophrenia

Cited by 231 publications

References 25 publications

Cost of treatment of schizophrenia in six European countries

Cost of treatment of schizophrenia in six European countries

Placebo and nocebo phenomena from the perspective of evidence based and person centered medicine

Clinical Experiences and Clinical Trials

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