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

Abstract

Introduction: Schyzophrenia is considered to be a serious mental disorder that affects over 21 million people all over the world, and is associated with disability that frequently affects the patient´s educational and working performance. In Argentina, two of the most widely used anti-psychotics in the treatment of this disorder are Haloperidol and Risperidone. Both of them are provided for free to patients without health coverage in the public health care facilities. Objective: In this paper we seek to evaluate the clinical and economic benefits of prescribing psychotropic therapies based on Haloperidol (a first-generation antipsychotic that is part of the group of the butyrophenone drugs) versus Risperidone (an atypical or second-generation antipsychotic-neuroleptic drug) on adult patients that have been diagnosed with schizophrenia. Methodology: An exhaustive survey of relevant articles published since 2006 up to the present day was carried out. Conclusions: Intermittent treatment usually fails to prevent relapses, due to irregular protection. That is why continuous treatment is more effective. Although the injectable formats of both drugs (Haloperidol DEPOT and long-term acting injectable Risperidone) have not proved to have significant differences regarding clinical effectiveness vis-a-vis the tablet formats, they show a higher cost-effectiveness ratio by reducing patients’ relapses. Moreover, long-term acting injectable Risperidone exhibits a higher ratio of clinical cost-benefits than Haloperidol DEPOT. Haloperidol is less expensive than Risperidone but shows a lower cost-effectiveness ratio; in comparison with Haloperidol, the treatment with Risperidone produces i) an improvement on the QALYs and iii) a significant reduction of the negative symptoms. Discussion: In most cases antipsychotic treatments are effective to control the positive and negative symptoms associated to schizophrenia, allowing patients to live in their communities without any impairments. However, it is extremely important to combine pharmacological treatment with other measures that constitute what is called psychosocial therapy.