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Cost-effectiveness of clozapine treatment in therapy-refractory schizophrenia
Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
1995 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 92, no 3, 199-201 p.Article in journal (Refereed) Published
Abstract [en]

The costs and effects of clozapine treatment of refractory schizophrenic patients have been discussed recently. This study shows that 18 months of clozapine treatment results in an improvement of symptoms and social functioning in approximately 70% of treatment-refractory schizophrenic patients, compared with treatment with conventional neuroleptics during a similar period of time. Treatment with clozapine reduces the cost of inpatient care but places increased demands on active rehabilitation resources in outpatient care. This leads to increased total costs in a short-term perspective, but clozapine treatment is cost-saving for annual maintenance therapy. These costs must be weighed against the positive effects on psychotic symptoms and social functioning.

Place, publisher, year, edition, pages
1995. Vol. 92, no 3, 199-201 p.
Keyword [en]
schizophrenia, clozapine, cost-effectiveness
National Category
Social Sciences Interdisciplinary
URN: urn:nbn:se:liu:diva-79065DOI: 10.1111/j.1600-0447.1995.tb09568.xOAI: diva2:538056
Available from: 2012-06-28 Created: 2012-06-28 Last updated: 2012-07-23Bibliographically approved
In thesis
1. Disability, rehabilitation and health economic assessment
Open this publication in new window or tab >>Disability, rehabilitation and health economic assessment
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Disability caused by long-term illnesses and diseases involves welfare losses through human suffering and huge societal costs. Rehabilitation of disabled individuals is a complex and growing field where health economic assessment studies could play a role in health policy and medical decision-making.

Aims: The overall aim was the application of a multidisdplinary framework of health economic assessment of rehabilitation technologies for disabled individuals. A specific aim was to examine the costs for some disabilitygroups, and another aim was to examine the cost-effectiveness of certain rehabilitation technologies for disabled individuals.

Methods: Six empirical studies were used. Cost analyses were applied to disabilities caused by long-term illnesses (Paper I), rheumatic· diseases (Paper II), and severe schiwphrenia (Paper III). A cost-effectivenessanalysis was performed on the rehabilitation of disabled patients with severe schizophrenia {Paper IV). Costutilily analyses were carried out on the rehabilitation of disabled patients with long-term illnesses (Paper V)and schizophrenia (Paper VI).

Results: The socioeconomic costs for the studied disability groups was SEK 1.9 billion for severe schizophrenia, SEK 25.6 billion for long term illness and SEK 62 billion for rheumatic diseases. The proportions of indirect productivity costs were considerable, 67-92% of total costs, and the social insurance expenditures were also high. Rehabilitation technologies based on co-operation between resource providers for disabled patients with schizophrenia improved health status by 26%, health-related quality of life by 27% and quality adjusted life years (QALY's). The costs for health care decreased significantly by 51% and sociely by 28%. Early rehabilitation of disabled patients with severe schizophrenia improved health status, social functioning and increased the health care costs. Rehabilitation of disabled patients with long-term illnesses did not improve health statu..~, quality of life and QALY's in the short run. The costs decreased for health care and the indirect costs increased. In optimizing the cost-effectiveness of rehabilitation technologies, disabled individuals must be precisely defined into homogeneous groups that match well-defined rehabilitation technologies. The costs for all resource providers in rehabilitation must be included in the cost concept in order to avoid underestimation of the socioeconomic costs. A financial analysis of transfer payments was valuable from a decision-maker perspective. The EuroQol-instrumem was sensitive in detecting significant changesin health status and health related qualily of life. One of the shortcomings in the study design i,s due to the lack of resources for health economic assessment studies. Long-term, randomized, controlled studies arc needed.

Conclusions: The application of the framework for health economic assessment to the rehabilitation of disabled individuals showed that the costs for disabilities in society were high, as was the proportion of indirectcosts. Co-operation among resource providers involved in rehabilitation can increase quality of life and save money for health care and society.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 62 p.
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 239
Disability, Rehabilitation, Cost-effectiveness, Cost-Utility, Quality of Life, Rehabilitering, Kostnadseffektivitet, Hälsoekonomi, Sjukvårdsekonomi, Livskvalitet
National Category
Social Sciences Interdisciplinary
urn:nbn:se:liu:diva-35036 (URN)24711 (Local ID)91-7373-110-2 (ISBN)24711 (Archive number)24711 (OAI)
Public defence
2001-09-12, Berzeliussalen, Hälsouniversitetet, Linköping, 13:00 (Swedish)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2014-08-28Bibliographically approved

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Jonsson, DickWålinder, Jan
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Center for Medical Technology AssessmentFaculty of Health SciencesPsychiatryDepartment of Psychiatry
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