2008/04/02 by Joseph Parks, Aaron Radke, Gordon Parker +5 · 1 citation
Medicine · Economics, Econometrics and Finance · Arts and Humanities · #Schizophrenia research and treatment #Health Systems, Economic Evaluations, Quality of Life #Mental Health and Psychiatry
paper · pdf · doi:10.1093/schbul/sbn019
openalex publication_date 2008/04/02 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22
Findings from 2 pivotal government-funded studies of comparative antipsychotic effectiveness undermine assumptions about the marked superiority of the more expensive second-generation "atypical" medications in comparison to the less expensive first-generation "typical" drugs. Because this assumption was the basis for the almost universal recommendation that these newer antipsychotics be used preferentially resulting in a 10-fold increase in state governmental expenditures on this class of medications over the past decade, a reassessment of policy is called for. To address the issue, the Medical Directors Council of the National Association of State Mental Health Program Directors critically reviewed findings of these studies in the context of other data and considered policy implications in the light of the obligations of state government to make available best possible and individually optimized treatment that is cost-effective. The Medical Directors Council unanimously adopted a set of recommendations to promote appropriate access, efficient utilization, and best practice use. We present our policy statement, in which we provide a succinct background, articulate general principles, and describe a set of 4 broad recommendations. We then summarize our understanding of the current state of knowledge about comparative antipsychotic effectiveness, best antipsychotic practice, and considerations for state policy that represent the basis of our position statement.