The objective of this study was to determine cost-effectiveness of a newantipsychotic, risperidone, and to compare with conventional antipsychotic,haloperidol, in chronic schizophrenia in Thailand. This single-blinded, randomizedprospective study included 88 chronic schizophrenic patients from Srithunya Hospital.Patients were randomly assigned to a 16-week treatment with either 2-40 mg ofhaloperidol or 2-10 mg of risperidone daily. Outcome measurement wereeffectiveness, side effects and costs of treatment. Effectiveness was assessed by thePositive and Negative Syndrome Scale (PANSS) and extrapyramidal side effects wasassessed by the Extrapyramidal Symptom Rating Scale (ESRS). Costs of treatmentwere divided into direct and indirect cost. Direct cost included hospitalization, drug,group psychotherapy, laboratory test, health personnel and transportation. Indirectcost included income loss of patients and their relatives. Because of selection bias, 60 patients remained at the end of study, 39 in risperidone and 21 in haloperidol group. Results showed that, number of patients with effective treatment was 74% in risperidone group (N=39) and 52% in haloperidol group (N=21). The extrapyramidal side effects was higher in haloperidol patients than risperidone. When the effectiveness was 100%, cost-effectiveness ratio of haloperidol was 77,379 baht/patient compared with 78,875 baht/patient of risperidone.In the sensitivity analysis of antipsychotic drug cost, the cost-effectiveness ratiocompared haloperidol with risperidone was 82,645 baht/patient and 72,347baht/patient, respectively.The findings suggest that clinical effectiveness is higher in risperidone thanhaloperidol and the most common adverse effect, extrapyramidal symptoms, is foundin haloperidol more than in risperidone. Treatment of schizophrenia with risperidonewhen compared to haloperidol, costs more but gives a better effectiveness. It isrecommended that risperidone will be more cost-effective if the price is reduced. Thisstudy can be used as a guidance to determine pharmacoeconomics of other drugs andtreatments.

M.Sc. (Pharmacy : Pharmacy Administration) มหาวิทยาลัยมหิดล ปี 2540

Haloperidol, Schizophrenia, risperidone, Psychotropic