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Risperidone versus haloperidol: II. Cost-effectiveness

A Davies1, P C Langley, N A Keks

  • 1Janssen-Cilag Pty. Ltd., Lane Cove, New South Wales, Australia.

Clinical Therapeutics
|April 2, 1998
PubMed
Summary
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Risperidone is more cost-effective for chronic schizophrenia than haloperidol, offering better outcomes at a lower price. This analysis used Australian guidelines to compare drug costs and patient responses over two years.

Area of Science:

  • Pharmacoeconomics
  • Health Economics
  • Psychiatric Drug Evaluation

Background:

  • Australia and Canada are unique among Western nations for having government guidelines on drug cost-effectiveness analysis.
  • Evaluating the economic impact of treatments for chronic schizophrenia is crucial for healthcare resource allocation.

Purpose of the Study:

  • To construct a pharmacoeconomic model comparing the cost-effectiveness of risperidone and haloperidol for chronic schizophrenia over two years.
  • To assess risperidone, haloperidol, and clozapine (as a third-line option) in terms of clinical outcomes and associated costs.

Main Methods:

  • Decision-analytic modeling was employed to compare clinical outcomes and costs.
  • A meta-analysis informed the probabilities of patient distribution across treatment outcome pathways.

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  • Direct costs, including medications, healthcare services, and accommodation, were comprehensively included.

    • Main Results:

    • Risperidone demonstrated a higher favorable outcome rate (78.9%) compared to haloperidol (58.9%) over two years.
    • The total two-year treatment cost was lower for risperidone ($15,549.00) versus haloperidol ($18,332.00).
    • Risperidone was found to be "dominant," offering a lower cost per favorable outcome ($19,709.00) than haloperidol ($31,104.00).

    Conclusions:

    • Risperidone is a more cost-effective treatment option than haloperidol for patients with chronic schizophrenia.
    • The difference in clinical response rates significantly influences the cost-effectiveness of these antipsychotic medications.
    • The study highlights the importance of pharmacoeconomic evaluations in guiding treatment decisions for chronic mental health conditions.