Cost and Outcome Implications of Using Typical and Atypical Antipsychotics in Ordinary Practice in Italy
J Clin Psychiatry 2003;64(11):1293-1299
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: 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 context of
community psychiatric care in Italy.
Method: Service costs and outcome data over a
24-month period (June-November 1999 to June-November 2001) were
compared between 2 cohorts of ICD-10-diagnosed subjects, the
first including patients receiving atypical and the second
typical antipsychotics, according to the type of treatment
received at the beginning of the study.
Results: At baseline, 183 subjects were under
treatment with antipsychotic drugs, of whom 73 were treated with
atypical agents. Most patients had a diagnosis of schizophrenia
and only a minority were first-contact patients. Conventional
antipsychotics were used in more chronic and elderly patients,
while atypicals were prescribed in more severe and recently
diagnosed cases. After background group differences were
controlled for, the use of atypical agents was neither predictive
of higher total health care costs nor of better patient outcome.
Predictors of higher costs and better outcome were severity of
illness at baseline and first-contact patients.
Conclusions: The introduction of atypical agents
had a small impact in terms of total health care costs and
outcome, and more important than the agent prescribed was the
severity of illness.