CUTLASS Cost Utility of the Latest Antipsychotics

SGAs were more expensive than first-generation antipsychotic medications, total antipsychotic medication cost was a relatively small proportion of total expenses

Abstract

The impact of first-generation antipsychotic medications (FGAs) vs second-generation antipsychotic medications (SGAs) on quality of life was evaluated. SGAs did not show superiority in improvement in the QLS. In fact, there was a numerical trend toward greater improvement with the FGA cohort. Healthcare costs were similar in both groups, with psychiatric inpatient hospitalization responsible for most of the expense. Although SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively).

Highlights

1. SGAs did not show superiority in improvement in the QLS. 
2. Healthcare costs were similar in both groups, with psychiatric inpatient hospitalization responsible for most of the expense. 
3. SGAs were more expensive than first-generation antipsychotic medications (FGAs).
4. Total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively)

Summary

1. SGAs did not show superiority in improvement in the QLS.
2. There was a numerical trend toward greater improvement with the FGA cohort.
3. Healthcare costs were similar in both groups with psychiatric inpatient hospitalization responsible for most of the expense.
4. SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively)
5. Criticisms include its administration by an external assessor and being affected by symptoms.
6. The PANSS total score in CUtLASS 1 accounted for only 30% of the variance in QLS scores at baseline

Conclusion:
SGAs did not show superiority in improvement in the QLS.
There was a numerical trend toward greater improvement with the FGA cohort.
SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively).

Summary

1. The impact of first-generation antipsychotic medications (FGAs) vs second-generation antipsychotic medications (SGAs) on quality of life was evaluated.
2. SGAs did not show superiority in improvement in the QLS. In fact, there was a numerical trend toward greater improvement with the FGA cohort. 
3. Healthcare costs were similar in both groups, with psychiatric inpatient hospitalization responsible for most of the expense. 
4. Although SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively).

Introduction

1. SGAs did not show superiority in improvement in the QLS. 
2. In fact, there was a numerical trend toward greater improvement with the FGA cohort. Healthcare costs were similar in both groups, with psychiatric inpatient hospitalization responsible for most of the expense. 
3. Although SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively).

Criticisms

Criticisms include its administration by an external assessor (although self-report has problems) and being affected by symptoms. Regarding the latter point, the PANSS total score in CUtLASS 1 accounted for only 30% of the variance in QLS scores at baseline.

Conclusion

1. In conclusion, there is no disadvantage in terms of quality of life, symptoms, or associated costs of care across 1 year in commencing treatment with FGAs rather than atypical SGAs in people with schizophrenia whose medication is being changed because of intolerance or inadequate response and who are treated in a pragmatic trial.
2. The impact of first-generation antipsychotic medications (FGAs) vs second-generation antipsychotic medications (SGAs) on quality of life was evaluated. 
3. SGAs did not show superiority in improvement in the QLS. In fact, there was a numerical trend toward greater improvement with the FGA cohort. 
4. Healthcare costs were similar in both groups, with psychiatric inpatient hospitalization responsible for most of the expense. 
5. Although SGAs were more expensive than FGAs, total antipsychotic medication cost was a relatively small proportion of total expenses (2.1% and 3.8% for FGAs and SGAs, respectively).