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. 2009 Sep-Oct;28(5):w794-808.
doi: 10.1377/hlthaff.28.5.w794. Epub 2009 Jul 21.

Comparative effectiveness research for antipsychotic medications: how much is enough?

David O Meltzer  1 , Anirban Basu, Herbert Y Meltzer
Affiliations

Comparative effectiveness research for antipsychotic medications: how much is enough?

David O Meltzer et al. Health Aff (Millwood). 2009 Sep-Oct.

Abstract

Second-generation antipsychotics have attracted practitioners' and policy-makers' attention, because of concerns over their health effects and costs. Comparative effectiveness data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)-a high-profile National Institutes of Health (NIH)-funded study-have been used to argue for restricting coverage for these costly drugs. But concerns about the design of CATIE and its associated cost-effectiveness analysis and uncertainty about the precision of these findings raise questions about this interpretation. Our work suggests that additional research to increase the precision of comparisons of the effectiveness of antipsychotics would be well worth the cost.

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Figures

EXHIBIT 3
EXHIBIT 3
Value Of Future Research To Prevalent And Incident Schizophrenia Cohorts At $50,000 Per Quality-Adjusted Life-Year (QALY), 2007–2087 SOURCE: Authors’ calculations. NOTE: CATIE is Clinical Antipsychotic Trials of Intervention Effectiveness.
EXHIBIT 4
EXHIBIT 4
Value Of Research And The Probability That The CATIE Conclusion Is Incorrect (That Perphenazine Is Not Cost-Effective) SOURCE: Authors’ calculations. NOTES: CATIE is Clinical Antipsychotic Trials of Intervention Effectiveness. Maximum value of research (gray line and points) relates to the left-hand y axis. Probability that CATIE conclusion is incorrect (black line and points) relates to the right-hand y axis. QALY is quality-adjusted life-year.
EXHIBIT 5
EXHIBIT 5
Net Expected Value Of Sample Information (At $50,000, $100,000, And $150,000 Per Quality-Adjusted Life-Year, Or QALY) SOURCE: Authors’ calculations.
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