Effectiveness and costs of flupentixol compared to other first- and second-generation antipsychotics in the treatment of schizophrenia

The purpose of this study is to analyse the effectiveness of flupentixol compared to other first- and second-generation antipsychotics for the treatment of schizophrenia in routine care. A retrospective cohort study was conducted using administrative data from four sickness funds covering 12.6 million insured. Patients discharged from hospital in 2003 with an ICD-10 diagnosis of schizophrenia were followed for 12 months. Rehospitalisation during follow-up was analysed using a hurdle regression model. Treatment costs were defined as cost of pharmaceutical and cost of inpatient care. Two thousand eight hundred ninety insured were included, of which 177 were treated with flupentixol during follow-up, while 429 and 2,284 were treated with other first-and second-generation antipsychotics, respectively. Compared to patients treated with flupentixol (21.0 days), predicted hospitalisation did not differ significantly for patients treated with other first- (21.3 days, p = 0.8313) or second-generation antipsychotics (25.6 days, p = 0.4035). Predicted treatment costs for the average patient were 4,193 a,not sign if treated with flupentixol, 4,846 a,not sign if treated with other first-generation antipsychotic, and 6,523 a,not sign if treated with a second-generation antipsychotic. Second-generation antipsychotics showed a clear advantage over flupentixol concerning extrapyramidal symptoms co-medication. The effectiveness of flupentixol preventing relapse in patients with schizophrenia appears to be similar to that of other first- and second-generation antipsychotics. However, the low treatment costs for patients treated with flupentixol could be explained by the small number of patients with readmissions (70 insured) and the larger share of patients treated with its depot formulation.