Cost-utility analyses of atypical neuroleptics:: a review

This review summarizes result, of pharmacoeconomic studies on direct and indirect costs of atypical and conventional anti psychotic treatment of patients with schizophrenic psychoses. Overall costs are enormous. Although not yet sufficiently investigated, the majority of studies thus far indicate that atypical antipsychotics either reduce costs or are cost neutral. This is true for direct costs and is most likely a result of better compliance and reduction of in-patient treatment costs. It is also true for indirect cost, specifically increased quality of life of patients and their family. Empirical data are available for clozapine and to a somewhat lesser degree for risperidone and olanzapine. Comparison within atypical antipsychotics and data regarding newer substances such as quetiapine and ziprasidone are almost completely lacking. Some initial data from Germany do point in the same direction, but actually there is a complete lack of randomized prospective studies for this important topic. This kind of data though seems essential for a rational development of the future infrastructure and budget planning.