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- Article; Proceedings Paper] Economic and health state utility determinations for schizophrenic patients treated with risperidone or haloperidol
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DocNo of ILP: 7424
Doc. Type: Article; Proceedings Paper
Title: Economic and health state utility determinations for schizophrenic patients treated with risperidone or haloperidol
Authors: Chouinard, G; Albright, PS
Full Name of Authors: Chouinard, G; Albright, PS
Keywords by Author:
Keywords Plus: COST-EFFECTIVENESS; CLOZAPINE; QUALITY; LIFE; SCALE; PREFERENCES; SAVINGS
Abstract: The current study uses utility analysis to assess economic and quality-of-life benefits of risperidone in patients with chronic schizophrenia. A retrospective analysis was performed on Positive and Negative Syndrome Symptoms (PANSS) data obtained from the published Canadian multicenter risperidone trial (part of the North American trial), Cluster analysis applied to endpoint PANSS scores, including all patients (N = 135), identified three clusters representing 130 patients with mild, moderate, and severe symptomatology. A narrative health state profile was written for each cluster, and 100 psychiatric nurses from Washington, DC, were asked to assign preference ratings to each one using linear analog and standard gamble (SG) methods. Mean utility values (confidence interval 95%) obtained from the SG ratings for the three health state profiles were 0.61 +/- 0.069 (mild); 0.36 +/- 0.073 (moderate); and 0.29 +/- 0.071 (severe). The mild health state (including the majority of risperidone 6 mg-treated patients) was rated by nurses to have a 0.25 +/- 0.0501 greater utility than the moderate health state (composed of the majority of haloperidol-treated patients). The results of these utility evaluations (SG) by the nurses were related to the clinical outcome for three of the six drug treatment groups (N = 65) by multiplying the percentage of patients in each of the three clusters, both at baseline and endpoint, who were receiving risperidone 6 mg/day, haloperidol, or placebo, by the utility value for the health state assigned to that cluster. The gain in utility for risperidone-treated patients was 2.6 times higher (0.125) compared with haloperidol-treated patients (0.049), and 7 times higher compared with placebo (-0.021). After multiplying the gain in utility of each treatment by the remaining expected life span for men and women, it was found that risperidone-treated patients obtained more than twice as many quality-adjusted years as haloperidol patients. The incremental drug treatment cost, divided by the incremental benefit of risperidone versus haloperidol was found to yield a favorable, generally accepted cost-utility ratio.
Cate of OECD: Basic medicine
Year of Publication: 1997
Business Area: gamble
Detail Business: gamble
Country: USA
Study Area:
Name of Journal: JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
Language: English
Country of Authors: UNIV MONTREAL,DEPT PSYCHIAT,MONTREAL,PQ H3C 3J7,CANADA; MCGILL UNIV,DEPT PSYCHIAT,ALLAN MEM INST,CLIN PHARMACOL UNIT,MONTREAL,PQ,CANADA; JANSSEN ORTHO INC,GOVT & HLTH ECON,DON MILLS,ON,CANADA
Press Adress: Chouinard, G (reprint author), LOUIS H LAFONTAINE HOSP,FERNAND SEGUIN RES CTR,7331 HOCHELAGA ST,MONTREAL,PQ H1N 3V2,CANADA.
Email Address:
Citaion:
Funding:
Lists of Citation: ADDINGTON DE, 1993, CLIN THER, V15, P917; Albright PS, 1996, CLIN DRUG INVEST, V11, P289; ANDREWS G, 1985, ARCH GEN PSYCHIAT, V42, P537; CHOUINARD G, 1980, CAN J NEUROL SCI, V7, P233; CHOUINARD G, 1993, J CLIN PSYCHOPHARM, V13, P25; COONS SJ, 1992, CLIN THER, V14, P850; Davies LM, 1990, PSYCHIATRIC B, V14, P522, DOI 10.1192/pb.14.9.522; DETSKY A, 1991, ONTARIO GUIDELINES E; DETSKY AS, 1990, ANN INTERN MED, V113, P147; Drummond MF, 1987, METHODS EC EVALUATIO; Fitton A, 1993, Pharmacoeconomics, V4, P131, DOI 10.2165/00019053-199304020-00007; FROBERG DG, 1989, J CLIN EPIDEMIOL, V42, P585, DOI 10.1016/0895-4356(89)90155-8; HEINRICHS DW, 1984, SCHIZOPHRENIA BULL, V10, P388; JUESCHKE R, 1992, PHARMACOECONOMICS, V1, P84; KAY SR, 1987, SCHIZOPHRENIA BULL, V13, P261; LAUPACIS A, 1992, CAN MED ASSOC J, V146, P473; MARDER SR, 1994, AM J PSYCHIAT, V13, P25; MELTZER HY, 1994, J CLIN PSYCHIAT, V55, P161; MELTZER HY, 1990, HOSP COMMUNITY PSYCH, V41, P892; MELTZER HY, 1993, AM J PSYCHIAT, V150, P1630; REID WH, 1994, HOSP COMMUNITY PSYCH, V45, P261; REVICKI DA, 1990, HOSP COMMUNITY PSYCH, V41, P850; *STAT CAN, 1985, INF CAN PUBL; TORRANCE GW, 1982, OPER RES, V30, P1043, DOI 10.1287/opre.30.6.1043; TORRANCE GW, 1987, J CHRON DIS, V40, P593, DOI 10.1016/0021-9681(87)90019-1; WYATT RJ, 1995, AM J PSYCHIAT, V152, P650
Number of Citaion: 26
Publication: WILLIAMS & WILKINS
City of Publication: BALTIMORE
Address of Publication: 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436
ISSN: 0271-0749
29-Character Source Abbreviation: J CLIN PSYCHOPHARM
ISO Source Abbreviation: J. Clin. Psychopharmacol.
Volume: 17
Version: 4
Start of File: 298
End of File: 307
DOI: 10.1097/00004714-199708000-00010
Number of Pages: 10
Web of Science Category: Pharmacology & Pharmacy; Psychiatry
Subject Category: Pharmacology & Pharmacy; Psychiatry
Document Delivery Number: XL995
Unique Article Identifier: WOS:A1997XL99500010
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