Comparing the cost-effectiveness of Haloperidol, Risperidone and Olanzapine in the treatment of schizophrenia using the net-benefit regression approach
AbstractSchizophrenia is a serious mental disease with an early onset mostly between the ages 15-25. It is characterised by distortions of thinking and perception with inappropriate or blunted personal and social behaviour as a result. Schizophrenia is usually a chronic disease with acute relapses. It is therefore expensive in terms of direct treatment costs due to re-hospitalisations and lifelong maintenance treatment. The disease is burdensome for the family who spends much time care-giving. It is hard for the individual who experiences a low quality of life and who has disadvantaged employment experiences resulting in low income and marginalisation. Various anti-psychotics, differing in costs and effects, can be used for treatment. An optimal treatment choice is important for the patient’s health and for the costs generated by the disease. Such an optimal choice should achieve a better balance between the resources expended and the resulting outcomes. Economic evaluation studies typically compare costs and effects between different treatment alternatives, and can assist in choosing. Many evaluation studies have already been performed, but most of them suffer from methodological problems. Part of the studies are attached to RCTs. These studies have the advantage that they are comparing the effects and costs of treatments for similar groups of patients (because of randomization). At the same time trials do not reflect everyday clinical practice and often suffer from other shortcomings, such as a relatively limited follow-up time (up to maximum 1 year), a small number of patients (mostly less than 100 patients), inadequate consideration of uncertainty, etc.. In everyday practice treatments are not random but chosen by the practitioner on the basis of patient characteristics and / or experience of the practitioner. A simple comparison of treatment costs and effects can then be misleading, since the results are distorted by patient and physician characteristics. Retrospective cohort-based evaluation studies often fail to account for baseline differences. Despite the relatively large number of evaluation studies already performed, Basu therefore concludes further studies of cost-effectiveness need to be carried out with careful consideration of the limitations of published analyses.
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Bibliographic InfoPaper provided by University of Antwerp, Faculty of Applied Economics in its series Working Papers with number 2007012.
Length: 29 pages
Date of creation: Jun 2007
Date of revision:
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