Risperidone cost-effectiveness

Only two randomized, controlled trials have been completed, and neither provides anything like compelling data (Table 2.6). Chouinard and Albright (1997) conducted a unique evaluation of a subset of patients from a previously conducted clinical trial. Subjects were categorized and profiled at baseline and end point according to clinical severity, and a group of psychiatric nurses were asked to rate various aspects of likely outcome and quality of life to each profile (mild, moderate or severe symptoms). Health state utilities were then calculated risperidone was found to provide more than double the number of quality-adjusted life years compared with haloperidol. Csernansky and Okamoto (1999) conducted a rather more conventional trial, but included no economic analyses. However, they did find that the use of risperidone substantially reduced relapse rates compared with haloperidol—an outcome likely to have a positive impact on cost-effectiveness. 

Davies A, Langley PC, Keks NA, et al (1998). Risperidone versus haloperidol II. Cost-effectiveness. Clin TherlO, 196-213. 

Finley PR, Sommer BR, Corbitt JL, et al (1998). Risperidone clinical outcome predictors and cost-effectiveness in a naturalistic setting. PsychopharmacolBull b y 75-81. 

When compared with typical neuroleptic drugs, risperidone may be more acceptable to those with schizophrenia. It may also have marginal benefits in terms of clinical improvement and its adverse effects profile. The superiority of risperidone in these respects may have been overestimated, owing to possible publication bias in favor of risperidone. Any marginal benefit has to be balanced against the greater cost of risperidone and its... 

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