A Review of Clinical and Economic Evaluations Applied to Psychotropic Therapies Used in the Treatment of Schizophrenia in Argentina

GONZÁLEZ, GISELA PAULA; MOSCOSO, NEBEL SILVANA; LAGO, FERNANDO PABLO

PharmacoEconomics - Open

Springer International Publishing

Lugar: Cham; Año: 2017

2509-4262

Abstract Schizophrenia is considered a serious mentaldisorder that affects over 21 million people worldwide, and isassociated with disability that frequently affects the patient?seducational and working performance. In Argentina, two ofthe most widely used antipsychotics in the treatment of thisdisorder are haloperidol and risperidone. Both are providedfree to patients without health coverage in public healthcarefacilities. In this paper we seek to review the clinical andeconomic benefits of prescribing psychotropic therapiesbased on haloperidol (a first-generation antipsychotic that ispart of the butyrophenone group of drugs) versus risperidone[an atypical or second-generation antipsychotic (neuroleptic)drug] in adult patients who have been diagnosed withschizophrenia. To achieve this objective, an exhaustivesearch of relevant articles published between 2006 and April2017 was conducted. This literature search showed thatintermittent treatment usually fails to prevent relapses due toirregular protection, therefore continuous treatment is moreeffective. Although the injectable formats of both drugs[haloperidol depot and long-acting injectable risperidone(LAIR)] have not proven to have significant differences withregard to clinical effectiveness vis-a`-vis the tablet formats,they showed a lower cost-effectiveness ratio by reducingpatients? relapses. Moreover, LAIR exhibits superior costeffectiveness compared with haloperidol depot. Haloperidolis less expensive than risperidone but is less cost effective; in comparison with haloperidol, treatment with risperidoneproduces (1) an improvement in quality-adjusted life-years,and (2) a significant reduction in negative symptoms. In mostcases, antipsychotic treatments are effective in controllingthe positive and negative symptoms associated withschizophrenia, allowing patients to live in their communitieswithout any impairments. However, it is extremely importantto combine pharmacological treatment with other measuresthat constitute psychosocial therapy.