The NHS Centre for Reviews and Dissemination has called for research that clearly supports the everyday use of "atypical"antipsychotics, saying that such trials "are long overdue".
The latest issue of Effective Health Care, published on December 9, says that "atypical" antipsychotics may improve the efficacy of treatment, may be more acceptable to patients and may have fewer side effects than older drugs but it describes them as a refinement rather than a revolution.
The bulletin states that the quality of much of the research relating to "atypical" antipsychotics is poor and has not improved over the past 50 years. It dismisses the argument that direct drug costs are offset by indirect costs and reduced hospitalisation. If the NHS is to fund these drugs, future trials must use interventions and outcomes that are familiar to health professionals who treat people with schizophrenia, it says. Overall, the quantity and quality of economic evidence is not sufficient to enable decision-makers to choose between the drugs with any certainty, although it adds that US studies have suggested that clozapine and risperidone may be "cost neutral" compared with conventional antipsychotics. The bulletin describes drug treatment of schizophrenia as representing a small proportion of the total outlay, citing long-term care as making up the bulk of direct costs to society.
The bulletin is based on a set of systematic reviews from the Cochrane Schizophrenia Group, some of which form the basis of a forthcoming report commissioned by the NHS Health Technology Assessment (HTA) programme.
Five leading pharmaceutical companies have joined forces to form the Pharmaceutical Schizophrenia Initiative. This is a group that will campaign to raise public and professional awareness and understanding of schizophrenia "in an effort to ensure improved access to treatment". The companies involved are Astra Zeneca, Eli Lilly, Janssen-Cilag, Novartis Pharmaceuticals and Pfizer, which are all involved in the development and manufacture of "atypical" antipsychotics. The initiative was launched on December 8.