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Research Highlights
Study Questions Benefits of Costly Schizophrenia Drug
November 29, 2003
A study at 17 VA hospitals comparing an older, pennies-a-day schizophrenia drug with a newer, far more expensive one found little advantage to the high-ticket drug. The researchers compared haloperidol, one of an older class of schizophrenia drugs called typical antipsychotics, to olanzapine, the most expensive among the newer atypical antipsychotics. Used alone, the older medications are more likely to cause troubling side effects such as tremors and twitches. But the study had doctors prescribe haloperidol as they would ideally in actual practice-accompanied from the outset by another drug, benztropine, to minimize side effects. The randomized, double-blinded, one-year study showed little difference in the overall effectiveness of the drugs. However, there is a whopping difference in price: Olanzapine costs more than $8 per day per patient, based on VA figures, compared to just about 10 cents per day for the haloperidol combination. And the higher-priced drug didn't lead to any significant reduction in hospital or outpatient costs.
JAMA. 2003 Nov 26; 290(20): 2693-702. Effectiveness and cost of
olanzapine and haloperidol in the treatment of schizophrenia: a randomized
controlled trial. Rosenheck R, Perlick D, Bingham S, Liu-Mares W, Collins J,
Warren S, Leslie D, Allan E, Campbell EC, Caroff S, Corwin J, Davis L,
Douyon R, Dunn L, Evans D, Frecska E, Grabowski J, Graeber D, Herz L, Kwon
K, Lawson W, Mena F, Sheikh J, Smelson D, Smith-Gamble V; Department of
Veterans Affairs Cooperative Study Group on the Cost-Effectiveness of
Olanzapine.
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