Document Detail


Effectiveness and cost of atypical versus typical antipsychotic treatment in a nationwide cohort of patients with schizophrenia in Germany.
MedLine Citation:
PMID:  22926592     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study investigates the effectiveness and cost of typical versus atypical antipsychotics in a nationwide German cohort of patients with schizophrenia. The study sample consisted of patients insured with 4 sickness funds (n = 8,610) who were followed up for 12 months after hospital discharge with a diagnosis of schizophrenia in 2003. Multivariate regression models were fitted to assess the relationship between outcome variables (rehospitalization, bed-days, prescriptions against adverse effects, cost) and medication type, sex, age, and severity. Severity was assessed by prior bed-days due to schizophrenia during 2000 to 2002. Risk of rehospitalization did not differ between groups but within each group severity (P = 0.0003). Males (P = 0.0016) and patients younger than 35 years (P < 0.0001) had a higher risk of rehospitalization. Number of bed-days was lower for treatment with typicals compared with atypicals (P < 0.0001); furthermore, bed-days depended on severity of disease (P < 0.0001). Prescriptions of drugs against extrapyramidal symptoms, anxiety, and agitation were higher for patients treated with typicals (P < 0.0001 for each). Mean predicted treatment cost per year was € 6442 for atypicals versus € 4443 for typicals (P < 0.0001). This study does not support unconditional superiority of atypicals over typicals, neither in terms of effectiveness nor in terms of cost.
Authors:
Tom Stargardt; Marc-Andreas Edel; Andreas Ebert; Reinhard Busse; Georg Juckel; Christian A Gericke
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  32     ISSN:  1533-712X     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-05     Completed Date:  2013-01-16     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  602-7     Citation Subset:  IM    
Affiliation:
Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany. Tom.Stargardt@wiso.uni-hamburg.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Antipsychotic Agents / adverse effects,  economics,  therapeutic use*
Cohort Studies
Cost-Benefit Analysis
Female
Follow-Up Studies
Germany
Health Care Costs*
Humans
Length of Stay
Male
Multivariate Analysis
Outcome Assessment (Health Care)
Patient Readmission / statistics & numerical data
Regression Analysis
Retrospective Studies
Schizophrenia / drug therapy*,  economics
Severity of Illness Index
Young Adult
Chemical
Reg. No./Substance:
0/Antipsychotic Agents
Comments/Corrections
Comment In:
Evid Based Ment Health. 2013 May;16(2):36   [PMID:  23349237 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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