Direct Costs of Schizophrenia in Italian Community Psychiatric Services

Garattini, Livio; Rossi, Carlotta; Tediosi, Fabrizio; Cornaggia, C; Covelli, Giampiero; Barbui, Corrado; Parazzini, Fabio

doi:10.2165/00019053-200119120-00004

Cited by 23 publications

(24 citation statements)

References 21 publications

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“…2.8 of all combined health service and community social care expenditures, and over 5 of all in-patient linked expenditure [2]. This consistent pattern of high levels of direct cost associated with schizophrenia is similar to that observed in other developed countries, including Germany [3,4,5,6].…”

supporting

confidence: 78%

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany

Beard¹,

Maciver²,

Clouth

et al. 2006

Eur J Health Econ

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Second-generation atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, ziprasidone, amisulpride and ariprazole offer the potential to reduce the significant health care resource demands in the treatment of schizophrenia through improved levels of initial clinical response and reduced levels of long-term acute relapse. However, the optimal sequencing of these drugs remains unclear. To consider this issue from a health economic viewpoint a decision model approach was used comparing healthcare costs and clinical outcomes when treating patients with alternative sequences of atypical antipsychotic treatment. Treated patients were assumed to be in a current acute episode with at least a 10-year history of disease and to be naive to previous atypical treatments. Treatment strategies were based on either first-line olanzapine or risperidone with switching to the alternative drug as second-line treatment following an inadequate clinical response to first-line drug therapy. Clinical response data were derived from a pivotal published comparative study of both olanzapine and risperidone. Published data on the long-term use of antipsychotic drugs where used wherever possible to populate the model for relapse rates during the maintenance phase. Health care resource data were defined for Germany based on expert clinical opinion. A treatment strategy of first-line olanzapine was shown to be cost saving over a 1-year period, with additional clinical benefits in the form of avoided relapses. The model suggests that over the first year of treatment a strategy of first-line olanzapine is associated with lower risk of additional relapse (0.33 fewer acute relapses per 100 patients per year) and with cost savings (euro 35,306 per 100 patients per year). There is a need for longer term direct in-trial comparisons of atypical antipsychotics to confirm these indicative results.

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supporting

confidence: 78%

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany

Beard¹,

Maciver²,

Clouth

et al. 2006

Eur J Health Econ

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“…Questa patologia psichiatrica è caratterizzata dalla presenza di sintomi psicotici, comportamento catatonico, riduzione dei contatti sociali e appiattimento affettivo. I pazienti schizofrenici presentano severi problemi di disabilità che provocano gravi ripercussioni nella sfera sociale, professionale e familiare [9][10][11], contraddistinti da frequenti episodi psicotici che a volte possono essere accompagnati da deliri e allucinazioni, aggressività, violenze su persone o cose e tentativi di suicidio.…”

Section: * Pharmes Studi DI Valutazione Economica Milanounclassified

La valutazione economica del trattamento farmacologico con antipsicotici nella schizofrenia: una revisione sistematica della letteratura

Ravasio¹

2005

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Farmeconomia e percorsi terapeutici 2005; 6 (1) © SEEd Tutti i diritti riservati R. Ravasio INTRODUZIONELa schizofrenia colpisce circa l'1% della popolazione generale, con un tasso di prevalenza dello 0,5-1% e con un'incidenza annua dello 0,1 0 / 00 [1]. Il tasso di mortalità ad essa associato risulta essere doppio rispetto a quello della popolazione generale [2]. I pazienti schizofrenici sono caratterizzati inoltre da maggiori rischi di comorbilità [3], di esclusione sociale [4] e da un alto rischio di suicidio (10-25%) [5]. Questo spiega come, a prescindere dallo stato di salute direttamente correlato alla patologia, le condizioni generali di salute di un paziente schizofrenico siano caratterizzate da una aspettativa di vita mediamente inferiore del 20% rispetto a quella della popolazione generale [6].Diversamente da altre malattie che possono essere trattate e guarite, questa è una malattia cronica che accompagna il paziente per tutta la vita. Di solito la schizofrenia vieLa valutazione economica del trattamento farmacologico con antipsicotici nella schizofrenia: una revisione sistematica della letteratura R. Ravasio* ABSTRACT Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely. The introduction of second-generation antipsychotics, also defined as atypicals, has increased the therapeutic options available for individuals with schizophrenia. Potential benefits of these agents include a more favourable profile in terms of positive and negative symptoms, less adverse effects and better cognitive functioning than first-generation antipsychotics. It is uncertain whether atypical antipsychotic agents, as prescribed in ordinary practice, are a cost-effective alternative to conventional agents. This study examined the financial and clinical implications of using atypical antipsychotics in the treatment of schizophrenia, considering both related costs and consequences. To elaborate the paper, we reviewed 8 economical studies regarding the comparison between atypical and typical antipsychotics, published in the years 1998-2004. In 5 studies atypical antipsychotics were cost-saving compared to typical, in 2 studies they were cost-neutral and in one study they resulted cost-effective. Consequently typical antipsychotics were cost-saving just in one study.

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“…Of this total cost, 53.2% were direct costs of treating schizophrenia and 46.8% were indirect costs due to lost productivity, incarceration and family care giving [19]. Meanwhile, COI studies have been conducted in many countries and information on total and average individual direct and indirect costs are available [20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

Section: Cost Of Schizophreniamentioning

confidence: 99%

“…While in the USA, in 1990 the proportion of drug costs on total direct costs was assessed at 2.3% [19]. Studies conducted during the mid-1990s found higher proportions of 6-10% [23,46,48], and in more recent studies the proportion was found to be between 10 and 16% [31,38,47]. The increase of the proportion of drug costs on total costs results from a general increase in antipsychotic drug use and change of prescription practice which is characterized by a decreasing use of first-generation conventional antipsychotics and an increasing use of second-generation atypical compounds [49][50][51][52][53][54].…”

Section: Direct Costs Assessmentmentioning

confidence: 99%

“…Analysis of the factors influencing the costs of schizophrenia have been performed in several countries [21,22,27,29,31,36,[58][59][60][61][62][63], however, with only one exception, all of these COI studies considered only the direct costs resulting from the treatment of schizophrenia and disregarded indirect costs [27]. Analysis of the factors influencing the direct costs of schizophrenia usually have been performed by means of multiple regression analysis [64].…”

Section: Factors Influencing the Costs Of Schizophreniamentioning

confidence: 99%

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Impact of antipsychotic medication on the cost of schizophrenia

Kilian

Becker

2005

Expert Review of Pharmacoeconomics & Outcomes Research

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A systematic literature search regarding the factors influencing the costs of schizophrenia and of comparative studies on the impact of antipsychotic treatment on the costs of schizophrenia between 1990 and 2004 was conducted. Altogether, 11 studies on factors influencing the costs of schizophrenia and 39 pharmacoeconomic studies on the comparative effects of antipsychotic medications on costs of schizophrenia were identified. Considering the factors influencing the costs of schizophrenia, the results of the review revealed only little systematic knowledge due to a great variation of methodologic standards and variables included. With regard to the effects of antipsychotic treatment, most studies compared atypical with conventional antipsychotic compounds. Results of these studies are inconsistent, and due to differences in methodologic standards, it is not possible to draw an evidence-based conclusion on the economic effects of a particular type of antipsychotic treatment. Consensus on the main outcome indicators of antipsychotic treatment and common standards of outcome measurement as well as economic analysis methods are necessary to overcome the current lack of empirical evidence.

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Direct Costs of Schizophrenia in Italian Community Psychiatric Services

Abstract: Despite the limitations of the study related to the short period considered, we believe this study offers some interesting information on the burden of schizophrenia, a disease for which its cost has received limited attention so far in Italy.

Cited by 23 publications

References 21 publications

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany

La valutazione economica del trattamento farmacologico con antipsicotici nella schizofrenia: una revisione sistematica della letteratura

Impact of antipsychotic medication on the cost of schizophrenia

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