Effectiveness and cost of atypical versus typical antipsychotic treatment in a nationwide cohort of patients with schizophrenia in Germany

Stargardt, Tom, Edel, Marc-Andreas, Ebert, Andreas, Busse, Reinhard, Juckel, Georg and Gericke, Christian A. (2012) Effectiveness and cost of atypical versus typical antipsychotic treatment in a nationwide cohort of patients with schizophrenia in Germany. Journal of Clinical Psychopharmacology, 32 5: 602-607. doi:10.1097/JCP.0b013e318268ddc0


Author Stargardt, Tom
Edel, Marc-Andreas
Ebert, Andreas
Busse, Reinhard
Juckel, Georg
Gericke, Christian A.
Title Effectiveness and cost of atypical versus typical antipsychotic treatment in a nationwide cohort of patients with schizophrenia in Germany
Journal name Journal of Clinical Psychopharmacology   Check publisher's open access policy
ISSN 0271-0749
1533-712X
Publication date 2012-10-01
Sub-type Article (original research)
DOI 10.1097/JCP.0b013e318268ddc0
Volume 32
Issue 5
Start page 602
End page 607
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
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 [Euro sign]6442 for atypicals versus [Euro sign];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.
Keyword Typical antipsychotic treatment
Atypical antipsychotic treatment
Schizophrenia
Cost and effectiveness
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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