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Second-generation antipsychotics: reviewing the cost-effectiveness component of the CATIE trial
Robert Rosenheck1, Marvin Swartz, Joseph McEvoy
1Yale Medical School, Northeast Program Evaluation Center (182), VA Connecticut Health Care System, 950 Campbell Ave., West Haven, CT 06516, USA. robert.rosenheck@yale.edu.
Abstract:
The cost-effectiveness component of the 18-month CATIE trial of schizophrenia pharmacotherapy (n = 1460) showed that the first-generation antipsychotic perphenazine was US$300-600 per month less expensive than each of four second-generation antipsychotics, and no less effective across multiple measures. We consider whether or not each of eight potential methodological limitations could weaken this conclusion: follow-up rates, study duration, sample characteristics, the choice of outcome measures, exclusion of patients with tardive dyskinesia from assignment to perphenazine, choice of study drugs and doses, reliance on intention-to-treat analysis, and differences in prestudy treatment. We conclude that results of CATIE are robust to these limitations. Perphenazine seems to have been a more representative choice for first-generation antipsychotic comparison treatment than haloperidol.
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