medications not cost-effective
Two Yale studies question the economics of medications in the two most widely prescribed and costly classes of psychiatric medications.
One study found that a new and more expensive antipsychotic drug is not more effective than a less costly, older one, and the second study found that industry-associated economic studies of antidepressants favor the companies' new drugs when determining costs and cost-effectiveness.
Costs and value of newer medications are at the forefront of current debates including the purchase of medications from Canada and the new Medicare coverage of prescriptions.
The first study at 17 Veterans Affairs (VA) hospitals compared an older, pennies-a-day schizophrenia drug with a newer, more expensive one.
There was little advantage to the higher priced drug, according to Dr. Robert Rosenheck, director of the VA's Northeast Program Evaluation Center in West Haven and a professor of psychiatry and public health at the School of Medicine. Rosenheck was the lead author of the study, which appeared in the Nov. 26 issue of the Journal of the American Medical Association.
The study represents the first long-term, rigorously designed experimental study of the newer drug, olanzapine, which has U.S. sales of $2 billion annually. In fiscal 2002, the VA spent $208.5 million overall on atypical antipsychotics -- $106.6 million for olanzapine alone.
The researchers compared haloperidol, a typical antipsychotic, to olanzapine, the most expensive among the newer atypical antipsychotics. The study found no differences between the drugs in reducing schizophrenia symptoms or improving quality of life.
Olanzapine costs more than $8 per day per patient, based on VA figures, compared to about six cents per day for haloperidol.
The second study by Dr. Bruce Baker, deputy director of the Treatment Research Program and assistant professor in the Department of Psychiatry, found that economic studies of newer antidepressants sponsored by drug companies favor the companies' own drugs over the older drugs to a greater extent than studies that are not sponsored by the industry.
In 2002, newer antidepressants were listed as five of the top 20 drugs by sales dollars and accounted for over $9 billion in sales.
There is widespread concern in the scientific community about potential sponsorship influence on research, especially in those studies focusing on the cost or cost-effectiveness of drugs.
Baker's study, in the December issue of the British Journal of Psychiatry, is the first to quantitatively analyze economic studies of psychiatric medications.
-- By Jacqueline Weaver
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Studies say newer psychiatric medications not cost-effective
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