Clinical equivalence of generic clozapine

To determine if mental health service utilization increases when patients are converted to generic clozapine.

About 125 patients taking clozapine in a community mental health clinic were switched from Novartis Clozaril to generic clozapine (Mylan Pharmaceuticals). Serum clozapine levels were obtained 2 weeks before, and 2 weeks after, the switch to generic clozapine. The number of outpatient visits, emergency room visits, and hospitalizations in the year prior to the switch were compared to those in the year following the switch, to determine service utilization.

Psychiatric emergency room visits decreased, but clozapine serum levels, inpatient hospital days, partial hospital admissions, and outpatient psychiatrist visits did not change after the switch to generic clozapine.

There were no significant increases in mental health service utilization after the conversion to Mylan generic clozapine. The switch to Mylan generic clozapine was cost effective, as the reduction in pharmacy costs was not offset by increased utilization costs.