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Outcome of clozapine treatment for patients with treatment-resistant schizophrenia in a local clinical service

Dorset Healthcare NHS Trust, Jessopp House, Mill Lane, Wimborne, Dorset BH21 1HG

Laurence Mynors-Wallis, Consultant Psychiatrist

Dorset Healthcare NHS Trust, Alderney Hospital, Poole, Dorset BH12 4NB

AIMS AND METHOD

The aim of this study was to examine the impact of prescribing clozapine for a cohort of patients with treatment-resistant schizophrenia in a local clinical service. Information was collected about the use of health care resources in the six months before and the six months after starting clozapine. Information was also recorded as to the effect of clozapine on daily living skills and overall clinical improvement.

RESULTS

The introduction of clozapine was associated with clinical benefits both in terms of overall clinical improvement and daily living skills. The introduction of clozapine was cost neutral in the first six months when taking into account both drug costs and total health care costs. The reduction in hospital bed usage did not occur until the third and fourth year following the introduction of clozapine.

CLINICAL IMPLICATIONS

Although the drug costs of clozapine are higher than the use of traditional neuroleptics for treatment-resistant schizophrenia, the immediate overall costs of introducing clozapine were no higher than before the drug was introduced. Savings in hospital bed usage did not occur until after a period of rehabilitation. It is our impression that the clinical improvement brought about by clozapine enabled patients to benefit from the rehabilitation services to a greater extent than before the drug was started.

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				P. Thieda, S. Beard, A. Richter, and J. Kane An Economic Review of Compliance With Medication Therapy in the Treatment of Schizophrenia Psychiatr Serv, April 1, 2003; 54(4): 508 - 516. [Abstract] [Full Text] [PDF]