Drugmakers and patient groups have responded swiftly to a study which claims that an older antipsychotic drug is just as effective and less expensive to treat patients with schizophrenia than newer products such as AstraZeneca’s Seroquel (quetiapine) and Eli Lilly’s Zyprexa (olanzapine).

In the latest analysis from the CATIE study, funded by the US National Institutes of Health and published in the American Journal of Psychiatry, researchers compared cost and quality of life factors for Seroquel, Zyprexa, Pfizer’s Geodon (ziprasidone) and Johnson & Johnson’s Risperdal (risperidone) with the first-generation treatment perphenazine.

The results showed that monthly costs, including factors such as

hospitalisation and social services, were about 40%-50% higher for patients who received second-generation antipsychotics compared to those on perphenazine. The researchers also added that there was no “statistically significant” difference in overall efficacy between first and second-generation treatments, for symptom relief and side effect burden.

One size doesn't fit all, drugmaker says

AstraZeneca, which saw its shares drop 2.2% as the study was published, responded by saying that “a one-size-fits-all approach to treating people with schizophrenia is not feasible” and, because no one medicine has been shown to work for all people with the condition, “patients and their doctors need multiple treatment options.”

The company added that the savings gained with perphenazine needs to be evaluated against the potential long-term risks and associated costs for both first and second-generation antipsychotics, and this “long-term comparison could not be fully addressed” in the CATIE study.

Lilly noted that the analysis placed Zyprexa as the most cost effective among the four newer-generation drugs studied but also said that the data from the analysis was limited due to a high drop-out rate, short time-span and adjustments for patients hospitalised in the past.

Ken Duckworth, medical director at the National Alliance on Mental Illness patient group, said “the study’s significance” lies in its limitations, and added that it “clearly would not justify” policies that would restrict access to any particular medication or “would thoughtlessly force patients or doctors” who are satisfied with a current treatment to change just because it might be less expensive.