[Consumption and cost of antipsychotic drugs]

In recent years, new atypical antipsychotic drugs have been marketed. This study aims to analyze the evolution of the consumption pattern and pharmaceutical cost of the antipsychotic drugs during the last years and the impact that the new atypical antipsychotic drugs have had.

Based on the ECOM database of the Ministry of Health and Consumer Affairs of Spain, the sales data of the antipsychotic drugs in Catalonia during the 1990-2001 period have been chosen. The drugs have been classified into typical or classical and atypical. Consumption data have been expressed in daily defined dose (DDD) per 1,000 inhabitants and per day of treatment (DID), and cost data in constant euros.

Antipsychotic consumption increased from 3.31 DID in 1990 to 6.04 DID in 2001. Typical drugs consumption decreased (from 100 % consumption in 1990 to 46 % in 2001) and that of the atypical ones increased (from 1% consumption in the year 1993 to 54% in the year 2001). A change in the use pattern of different drugs is verified. In the year 1990, the most consumed drugs were flupenthixol (0.86 DID) and haloperidol (0.67 DID), and in the year 2001 olanzapine (1.69 DID) and risperidone (1.30 DID). The drugs with a greater increase in consumption were olanzapine, which multiplied its consumption five fold from 1997 to 2001 and risperidone, which multiplied it by 20 from 1994 to 2001. During the study period, the cost increased 13 times, above all due to increase in cost of atypical antipsychotics (from less than 1 % of the total cost in 1993 to 92 % of the total cost in 2001). The DDD cost of antipsychotics increased (6.48 euros in 1990 and 20.31 euros in 2001). However, that of the typical antipsychotics decreased (6.48 euros in 1990 and 4.62 euros in 2001) and that of the atypical ones increased (2.06 euros in 1993 and 15.69 euros in 2001).

The marketing of the new atypical antipsychotic drugs has had an extraordinary impact on antipsychotic drug consumption and cost. The cost/effectiveness ratio of the new atypical antipsychotic drugs in the clinical practice should be evaluated to determine the economic resources aimed at costs of the different antipsychotic drugs.