[The impact of antipsychotic medication on the incidence and the costs of inpatient treatment in people with schizophrenia: results from a prospective observational study]

Abstract

Subject: Subject of the study is the analysis of the impact of antipsychotic medication on the incidence and the costs of inpatient treatment in patients with schizophrenia.

Methods: In a prospective longitudinal study with 5 points of measurement incidence and the costs of inpatient treatment, the type of antipsychotic medication, as well as the clinical and social characteristics of 307 outpatients with the diagnosis of schizophrenia (ICD 10 F 20.0) were assessed over a period of 2.5 years. The impact of antipsychotic medication on the incidence of inpatient treatment was analysed by means of a random-effect logit model. The impact of antipsychotic medication on the costs of inpatient treatment was analysed by means of a random-effect tobit model. Selection effects were controlled by means of propensity scores.

Results: Patients who received antipsychotic treatment with conventional, new atypical or depot neuroleptics had a lower incidence of inpatient treatment and caused lower costs in comparison to patients without antipsychotic treatment. The same effect was found for patients who received a combined treatment with conventional and depot neuroleptics. No effects were found for clozapine or for a combination treatment with conventional and atypical neuroleptics. No significant differences between the effects of conventional, new atypical or depot-neuroleptics were found.

Conclusion: The application of neuroleptic medication in schizophrenia treatment generally reduces the incidence and the costs of inpatient treatment. An extension of the use of clozapine or new atypical neuroleptics to all patients with schizophrenia will not generally improve the treatment effectiveness regarding to the incidence and the costs of inpatient treatment.