Economic Outcomes of Risperidone in Comparison to Typical Neuroleptic Agents for Treatment-Resistant Psychosis: A Community-Based Study

Abstract

Objective: To compare the costs of treatment for psychosis with risperidone and typical neuroleptics in severely ill outpatients treated in a community mental health setting. Methods: This was an open, retrospective, controlled cohort comparison of actual costs of psychiatric treatment in a group of 17 patients treated with risperidone for psychotic disorders and 15 typical neuroleptic-treated controls matched for severity of illness. Assignment to the two groups was nonrandomized, and outcome data were gathered for the duration of the study for each subject, with dropouts included. Results: Risperidone use did not lead to increased treatment expenses compared with typical neuroleptic use in a mean of approximately nine months follow-up. The median overall cost per patient per year was $2,703 in the risperidone group, compared with $2,551 in the typical neuroleptic group (p = 0.64). Increased drug costs (mean expenses per patient per year: $1,631 for risperidone vs. $357 for typical neuroleptics; p = 0.005) were offset by reduced expenses due to decreased hospitalization rates (mean expenses per patient per year: $1,379 for risperidone vs. $3,920 for typical neuroleptics; p = 0.04). Use of other outpatient services did not significantly differ between the two groups. Conclusions: Use of risperidone led to lower hospitalization rates in this severely ill sample and did not lead to greater overall expense than typical neuroleptic use.