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The Cost of Madness

— K.M.T.C.


 Mind Reading

 The Cost of Madness

 A Who's Who of Schizophrenia

As recently as the 1960s, the treatments for schizophrenia read like something out of science fiction. Electric shock. Lobotomy. Insulin-induced convulsions. Then along came the drugs.

“I've been on Seroquel, Stelazine, Klonopin, Cogentin and Wellbutrin,” said Joan, a middle-aged woman who has suffered from schizophrenia since she was 25. “Now I take Xanax, Elavil, and thiothixene.”

 Splintered Minds

With its treatment so heavily dependant on medications, schizophrenia is the nation's costliest mental illness, topping more than $33 billion annually in the United States.

Joan's case is typical, as a University of Georgia study of the state's Medicaid population shows. She takes some medications to control symptoms of schizophrenia and others to help with the side effects. And over the years, she has been switched from low-cost drugs to higher-cost medications with fewer side effects.

UGA psychologist Stephen Miller, along with Bradley Martin and Jeffrey Kotzan, both in the UGA pharmacy care administration department, examined the change in medication use and costs for 16,227 Georgia Medicaid-eligible schizophrenics. The eight-year study from 1990 to 1997 included schizophrenics who were more than 16 years old.

Their research found a slight increase in the use of antipsychotic medications during the study period and a big shift from traditional medications to newer, more expensive drugs with fewer side effects. Traditional medications cost about $40 per month per patient but produce side effects like sedation, weight gain, blurred vision, menstrual difficulty, low blood pressure, sexual dysfunction and Parkinson’s-like symptoms. Newer drugs — atypicals, clozapine and decanoates — run in the neighborhood of $150 to more than $300 per month with rare side effects or ones that take a long time to develop.

The switch to the new medications can stress drug budgets of those who foot the bills, including organizations like Medicaid. While the newer drugs cost more, patients on these drugs experience fewer hospitalizations than those on the traditional medications so overall costs to healthcare systems may not actually be higher. Not only that, but people who take the newer medications are more likely to be employed and earn salaries that exceed treatment costs, according to a newly published study in Schizophrenia Research by Miller, Martin and Rahul Ganguly, a graduate student in the UGA pharmacy care administration department.

Studies like these can help those healthcare systems that care for people with schizophrenia plan for increases in drug expenditures.




Research Communications, Office of the VP for Research, UGA
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