Comparison of Prescribing Patterns for Typical and Atypical Antipsychotics in Patients with Schizophrenia Before and After the Publication of the Phase I

Abstract

Objectives: This retrospective analysis compared the prescribing rates of typical versus atypical oral antipsychotics in the treatment of schizophrenia for 6 months before versus 6 months after the publication of the Phase 1 CATIE trial on September 22, 2005. Methods: Prescription and membership databases from COPE Behavioral Services in Tucson, AZ were utilized for determining prescribing rates of typical and atypical antipsychotics for pre- versus post-publication of the CATIE trial. Comparisons were made for gender, court order treatment, hospitalizations and length of stay, costs of services (case management, inpatient, lab, and other services), total number of prescriptions and number of tablets/capsules of typical and atypical antipsychotics, and cost of antipsychotic prescriptions. Results: There was no significant difference in prescribing rates for oral atypical and typical antipsychotics, cost of services, or hospitalization rates in the pre-publication (N=316) versus post-publication (N=336) groups. Atypical antipsychotics accounted for approximately 77% of antipsychotic prescriptions and for 98% of the total costs for antipsychotic therapy in the two time periods. During the 12-month study, the amount paid for atypical antipsychotic prescriptions was $ 1,026,004 versus $ 22,671 for typical antipsychotics. Conclusions: Prescribing patterns of oral typical and atypical antipsychotics for the treatment of schizophrenia did not change during the first six months after the publication of the phase I CATIE trail in this outpatient population. Atypical antipsychotics accounted for the majority of prescriptions and for the highest cost compared to other services provided despite similar efficacy to typical antipsychotics in the treatment of schizophrenia.