Cost-effectiveness of Clozapine Monitoring After the First 6 Months
Archives of General PsychiatryPublished 1 October 1996
Mingliang Zhang
Citations21
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
While the costs of monitoring patients with schizophrenia in the first 6-month period of clozapine treatment seem to be justifiable, monitoring thereafter may not be cost-effective because of the very low incidence of agranulocytosis in the later periods.
Abstract
While the costs of monitoring patients with schizophrenia in the first 6-month period of clozapine treatment seem to be justifiable, monitoring thereafter may not be cost-effective because of the very low incidence of agranulocytosis in the later periods.
Keywords
Medicine
Methods for the Economic Evaluation of Health Care Programmes
4,559 Citations2005Michael E Drummond, Mark J Sculpher +3 more
Journal of Health EconomicsMeasurement of health state utilities for economic appraisal
2,200 Citations1986George W. Torrance
A framework for economic appraisal is presented displaying the various components that must be measured, and showing how the three forms of analysis relate to the framework and to each other.
New England Journal of MedicineClozapine-Induced Agranulocytosis -- Incidence and Risk Factors in the United States
960 Citations1993Jose Ma. J. Alvir, Jeffrey A. Lieberman +3 more
The increasing risk of agranulocytosis with age and the reduced incidence after the first six months of treatment provide additional guidelines for the prescription and monitoring of clozapine treatment in the future.
Choice Reviews OnlineHealth status and health policy: quality of life in health care evaluation and resource allocation
774 Citations1993
This paper presents a strategy for Allocating Resources to Health Care and theoretical Foundations for Health-Related Quality of Life, and discusses the limits of Rationality in Allocating Health Resources.
New England Journal of MedicineClozapine
690 Citations1991Ross J. Baldessarini, Frances R. Frankenburg +2 more
American Journal of PsychiatryReduction of suicidality during clozapine treatment of neuroleptic- resistant schizophrenia: impact on risk-benefit assessment
439 Citations1995H.Y. Meltzer, Ghadeer Okayli
The results suggest a basis for reevaluation of the risk-benefit assessment of clozapine, i.e., that the overall morbidity and mortality of patients with neuroleptic-resistant schizophrenia are less with clozAPine treatment than with typical Neuroleptic drugs because of less suicidality.
The Canadian Journal of PsychiatryMortality in a Cohort of Patients with Schizophrenia: A Record Linkage Study*
373 Citations1991Stephen C. Newman, Roger Bland
Psychiatric ServicesEffects of Six Months of Clozapine Treatment on the Quality of Life of Chronic Schizophrenic Patients
340 Citations1990Herbert Y. Meltzer, Sarah Burnett +2 more
The effect of approximately six months of treatment with clozapine on the quality of life of 38 treatment-resistant schizophrenic patients was prospectively studied in an open trial and ratings tended to be negatively correlated with ratings on the Brief Psychiatric Rating Scale at baseline and at six months.
PubMedAgranulocytosis: incidence and risk factors.
239 Citations1994Richard J. Kavoussi, Jennifer Liu +1 more
This study suggests that sertraline is an effective treatment for impulsive aggressive behavior in personality disordered patients and supports the hypothesis that different symptom constellations/personality traits have different underlying biological substrates that may respond differentially to pharmacologic agents with specific modes of action.
European Journal of Clinical PharmacologyAgranulocytosis during treatment with clozapine
235 Citations1977J. Id�np��n-Heikkil�, Eeva Alhava +2 more
Within six months of the introduction of the new antipsychotic drug clozapine in Finland, 17 cases of neutropenia or agranulocytosis were recorded amongst about 3000 patients treated, with a high incidence of complications.
American Journal of PsychiatryCost effectiveness of clozapine in neuroleptic-resistant schizophrenia
211 Citations1993H.Y. Meltzer, Philip A. Cola +5 more
Clozapine produced a marked improvement in Brief Psychiatric Rating Scale total scores as well as positive negative symptom scores, Global Assessment scale scores, Quality of Life Scale scores, work functioning, capacity for independent living, and rehospitalization rates.
PubMedIncorporating utility-based quality-of-life assessment measures in clinical trials. Two examples.
161 Citations1989David Feeny, George W. Torrance
The utility approach and clinical decision making are being used in an on-going trial of two procedures for prenatal diagnosis in which major potential differences include quality-of-life effects.
Acta Psychiatrica ScandinavicaAgranulocytosis in patients treated with clozapine
152 Citations1977H. A. Amsler, L. Teerenhovi +3 more
No local factor, either genetic or environmental, was found which could have been responsible for the increased frequency of occurrence in Finland and the need to be aware of the risk and to take appropriate precautionary measures is emphasized.
Acta Psychiatrica ScandinavicaMortality and causes of death in schizophrenic patients in Denmark
139 Citations1990Preben Bo Mortensen, Knud Juel
A cohort consisting of 6178 people that were psychiatric inpatients with a clinical schizophrenia diagnosis in 1957 were followed up from 1957 through 1986, and their cause‐specific mortality was determined.
Psychiatric ServicesCost-Effectiveness of Clozapine for Treatment-Resistant Schizophrenic Patients
117 Citations1990Dennis A. Revicki, Bryan R. Luce +3 more
Clozapine therapy for treatment-resistant schizophrenic patients resulted in decreases in psychopathology and reductions in mental health service costs and economic benefits were observed after two years of clozAPine therapy.
The British Journal of PsychiatryAssessment of Costs and Benefits of Drug Therapy for Treatment-Resistant Schizophrenia in the United Kingdom
97 Citations1993Linda Davies, Michael Drummond
An analysis was conducted on the basis of available data to assess the economic consequences of clozapine therapy for people with moderate to severe schizophrenia in long-stay institutions or staffed group homes, with a view to providing an estimate of the likely costs and benefits of the drug.
Schizophrenia ResearchMortality in DSM-IIIR schizophrenia
86 Citations1992Donald W. Black, Ron Fisher
Mortality was investigated in 356 DSM-IIIR schizophrenics admitted to a university psychiatric hospital over a 12-year period and found that schizophrenia had nearly a three-fold increase in overall mortality.
European Journal of Clinical PharmacologyClozapine-induced agranulocytosis: A situation report up to August 1976
85 Citations1977Bernard M. Anderman, Rosemary Griffith
Results are given to show that strict adherence to precautionary measures reduces the mortality-rate of this condition and there is no evidence that clozapine- related agranulocytosis is more common than the phenothiazine-related disorder.
Psychiatric ServicesThe European Experience With Use of Clozapine
63 Citations1990Д. Набер, Hanns Hippius
Findings agree with those of other European studies and suggest that when hematological and other variables are carefully controlled, the benefits of clozapine therapy outweigh the risks.
Psychiatric ServicesA Two-Year Clinical and Economic Follow-Up of Patients on Clozapine
59 Citations1990Gilbert Honigfeld, John Patin
Patients on clozapine showed marked clinical improvement as measured by the Brief Psychiatric Rating Scale and had significantly lower rates of rehospitalization and hospitalization costs than a comparison group of schizophrenic patients who received standard neuroleptic treatment and who were considerably less psychotic at hospital admission.
PubMedG-CSF and the management of clozapine-induced agranulocytosis.
47 Citations1994S L Gerson
Evaluating the state-of-the-art management of patients with prolonged and profound severe granulocytopenia and the early use of hematopoietic growth factors prior to the onset of agranulocytosis and the use of these factors for the outpatient management of this disorder.
PubMedThe pharmacoeconomics of clozapine: a review.
44 Citations1994Herbert Y. Meltzer, Philip A. Cola
Clozapine has been found to produce superior outcome compared with prior treatment with typical neuroleptic drugs in Neuroleptic-resistant schizophrenia in dimensions that can be readily transformed into cost-utility measures such as decreased psychopathology, improved cognition, decreased rehospitalization, decreased suicide attempts, and better work function.
PubMedTreatment of clozapine-induced agranulocytosis with recombinant granulocyte colony-stimulating factor.
19 Citations1994Guy Gullion, H S Yeh
New England Journal of MedicineMandatory Monitoring for Side Effects
10 Citations1990Carl Salzman
Clozapine is a new neuroleptic drug that was released for clinical use in the United States in February 1990 under the trade name Clozaril.
JAMAControversy Grows Over Monitoring System for New Schizophrenia Drug
6 Citations1990Matthew J. Kleinerman
For many, clozapine makes hospital discharge a possibility that did not exist before, and the controversy has reached a pitch that suggests the government may soon intervene in determining how patients who are taking this drug are to be monitored.
