Skip to main content
SpringerLink
Log in

In the Aftermath of CATIE: How Should Administrators Value Atypical Antipsychotic Medications?

  • Original Paper
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

The wide scale use of expensive atypical antipsychotic medications has led to a dramatic increase in the proportion of direct costs schizophrenia being allocated for medications. Although there is evidence that the atypical antipsychotic, clozapine, may lead to cost savings in patients with refractory schizophrenia the cost-effectiveness of the other atypical antipsychotics remains in question. We therefore reviewed the published, long-term randomized, prospective cost-effectiveness treatment studies that compared an atypical to a typical antipsychotic. There were serious methodological problems with all. In general, those that were based on efficacy trials showed an advantage for atypicals while those based on effectiveness studies found the opposite. It appears that to the extent that studies mimic “real world” conditions they fail to support the cost-effectiveness of the atypical antipsychotics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Davis, J. M., Chen, N., & Glick, I. D. (2003). A meta-analysis of the efficacy of second-generation antipsychotics. Archives of General Psychiatry, 60, 553–564.

    Article  PubMed  CAS  Google Scholar 

  • Essock S. M., Frisman L. K., Covell N. H., & Hargreaves, W. A. (2000). Cost effectiveness of Clozapine compared to conventional antipsychotic medication for patients in state hospitals. Archives of General Psychiatry, 57, 987–994.

    Article  PubMed  CAS  Google Scholar 

  • Freedman, R. (2005).The choice of antipsychotic drugs for schizophrenia. New England Journal of Medicine, 353, 1286–1288.

    Article  PubMed  CAS  Google Scholar 

  • Kane, J., Honingfeld, G., Singer, J., & Meltzer, H. (1989). Clozapine for the treatment-resistant schizophrenic: A double-blind comparison with chlorpromazine. Archives of General Psychiatry, 45, 789–796.

    Google Scholar 

  • Leucht, S., Wahlbeck, K., Hamann, J., & Kissling, W. (2003). New generation antipsychotics versus low potency conventional antipsychotics: A systematic review and meta-analysis. Lancet, 361, 1581–1589.

    Article  PubMed  CAS  Google Scholar 

  • Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B., Severe, J., & Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 1209–1223.

    Article  PubMed  CAS  Google Scholar 

  • Luchins, D. J., Chiriac, I., Hanrahan, P., Goldman, M., Fabian, R., & Tolley, G. (2005). Allocating funds for medications and psychosocial interventions: How consumers would divide the pie. Psychiatric Services, 56, 799–801.

    Article  PubMed  Google Scholar 

  • Rosenheck, R. A. (2005). Effectiveness versus efficacy of second-generation antipsychotics: Haloperidol without anticholinergics as a comparator. Psychiatric Services, 56, 85–92.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Chicago, 5841 S. Maryland Ave MC3077, Chicago, Illinois, 60637, USA

    Daniel J. Luchins

Authors
  1. Daniel J. Luchins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel J. Luchins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luchins, D.J. In the Aftermath of CATIE: How Should Administrators Value Atypical Antipsychotic Medications?. Adm Policy Ment Health 33, 541–543 (2006). https://doi.org/10.1007/s10488-006-0049-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-006-0049-z

Keywords

Search

Navigation