A pharmacoeconomic evaluation of clozapine in one patient

Sandoz Canada Inc. began distributing clozapine in Canada under the Clozaril Support and Assistance Network (CSAN) in 1990. The costs associated with the required compliance to the CSAN program has prompted much debate regarding the ethical and clinical considerations in selecting patients to receive clozapine therapy. We undertook a one year cost-comparison analysis of clozapine therapy by assessing total mental health care costs for a patient with an extensive hospitalization history who was prescribed clozapine. Average yearly hospitalization costs were $17,413. The average yearly cost associated with clozapine therapy for this patient, with no hospital admissions was $8,411. The total health care cost for the year following initiation of clozapine was $17,828, compared to a cost of $68,423 in the year prior to clozapine, or $27,754 in an estimated average year. This case is representative of costs savings that can be achieved by using clozapine and breaking the institution-dependency of many schizophrenic patients.