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Effectiveness and costs of flupentixol compared to other first- and second-generation antipsychotics in the treatment of schizophrenia

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Abstract

Rationale

The purpose of this study is to analyse the effectiveness of flupentixol compared to other first- and second-generation antipsychotics for the treatment of schizophrenia in routine care.

Method

A retrospective cohort study was conducted using administrative data from four sickness funds covering 12.6 million insured. Patients discharged from hospital in 2003 with an ICD-10 diagnosis of schizophrenia were followed for 12 months. Rehospitalisation during follow-up was analysed using a hurdle regression model. Treatment costs were defined as cost of pharmaceutical and cost of inpatient care. Two thousand eight hundred ninety insured were included, of which 177 were treated with flupentixol during follow-up, while 429 and 2,284 were treated with other first-and second-generation antipsychotics, respectively.

Results

Compared to patients treated with flupentixol (21.0 days), predicted hospitalisation did not differ significantly for patients treated with other first- (21.3 days,p = 0.8313) or second-generation antipsychotics (25.6 days,p = 0.4035). Predicted treatment costs for the average patient were 4,193 € if treated with flupentixol, 4,846 € if treated with other first-generation antipsychotic, and 6,523 € if treated with a second-generation antipsychotic. Second-generation antipsychotics showed a clear advantage over flupentixol concerning extrapyramidal symptoms co-medication.

Conclusion

The effectiveness of flupentixol preventing relapse in patients with schizophrenia appears to be similar to that of other first- and second-generation antipsychotics. However, the low treatment costs for patients treated with flupentixol could be explained by the small number of patients with readmissions (70 insured) and the larger share of patients treated with its depot formulation.

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Acknowledgements

This study was kindly supported by an investigator-initiated trial grant from Bayer Vital GmbH. We are very grateful to the Techniker Krankenkasse, AOK Berlin, AOK Baden-Wuerttemberg and AOK Westfalen-Lippe for their kind support in granting access to the sickness fund databases and for their help with data extraction.

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Authors and Affiliations

  1. Hamburg Center for Health Economics, University Hamburg, Hamburg, Germany

    Tom Stargardt

  2. Department of Psychiatry, Ruhr University Bochum School of Medicine, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791, Bochum, Germany

    Paraskevi Mavrogiorgou & Georg Juckel

  3. National Institute of Health Research, Universities of Exeter & Plymouth, Plymouth, UK

    Christian A. Gericke

Authors
  1. Tom Stargardt
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  2. Paraskevi Mavrogiorgou
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  3. Christian A. Gericke
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  4. Georg Juckel
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Correspondence to Georg Juckel.

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Stargardt, T., Mavrogiorgou, P., Gericke, C.A.et al.Effectiveness and costs of flupentixol compared to other first- and second-generation antipsychotics in the treatment of schizophrenia. Psychopharmacology216,579–587 (2011). https://doi.org/10.1007/s00213-011-2256-x

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