Risperidone Compared With Olanzapine in a Naturalistic Clinical Study: A Cost Analysis
J Clin Psychiatry 2003;64(5):589-597
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Risperidone and olanzapine are
thought to have broadly similar clinical effects. This study was
designed as a cost analysis study comparing costs and
basic clinical outcomes of treatment with risperidone or
olanzapine in a naturalistic setting.
Method: The U.K. Risperidone Olanzapine Drug
Outcomes Studies in Schizophrenia (RODOS-UK) program consisted of
a retrospective review of medical notes and prescription charts
for 501 patients with schizophrenia or schizoaffective disorder
who had been admitted to the hospital for the treatment of
psychosis. The main outcome measure was cost of inpatient drug
treatment. Clinical outcomes (clinician-assessed and -documented
effectiveness, time to discharge) were also evaluated. Data were
collected and verified between June and September 2000.
Results: Clinical outcomes were similar for
risperidone and olanzapine. Clinician-assessed effectiveness was
similar for both treatments (78% risperidone, 74% olanzapine; p =
.39), but mean time to documented onset of effectiveness was
significantly shorter for those treated with risperidone versus
olanzapine (17.6 vs. 22.4 days; p = .01). Risperidone-treated
patients stayed a mean of 9 fewer days in the hospital compared
with olanzapine-treated patients (49 vs. 58 days; p = .007). The
possibility that these observed differences were a result of
different baseline characteristics could not be entirely
discounted. Mean ± SD doses of risperidone and olanzapine were
5.5 ± 2.4 mg/day and 14.1 ± 4.7 mg/day, respectively. The mean
daily cost of all inpatient drugs was significantly higher for
olanzapine than for risperidone (£5.63 vs. £3.92; p <
.0001). Mean total costs of all inpatient drugs were
significantly higher for olanzapine than for risperidone (£164
vs. £96; p < .0001), which partly reflected the longer mean
treatment duration for olanzapine compared with risperidone (44
vs. 37 days). Concomitant antipsychotic use was similar for both
groups (66% risperidone, 67% olanzapine). The number of patients
documented as experiencing adverse events was not different
between groups (22% risperidone, 19% olanzapine; p = .32).
Conclusion: Risperidone and olanzapine produced
broadly comparable clinical outcome in this cohort of
hospitalized patients, but the use of risperidone was associated
with significantly lower drug treatment costs.