A COMMENTARY ON IMPROVING CLOZAPINE ACCESSIBILITY AND REDUCING TREATMENT COST

Psychiatry Res. 2021 Feb:296:113644. doi: 10.1016/j.psychres.2020.113644. Epub 2020 Dec 14.

Abstract

Clozapine is vastly underutilized in the United States and many other countries. The most commonly cited reason for this is the requirement for frequent blood monitoring, which continues for the duration of treatment. Despite the notoriety clozapine achieved early in its development, accumulated evidence has demonstrated that close blood monitoring beyond the first year of treatment yields minimal safety benefits. Many health care systems have relaxed clozapine blood monitoring requirements during the COVID-19 pandemic for practical reasons, and this presents an opportunity to implement permanent, long overdue changes in mandated monitoring that reflect what has been learned about the real risk for blood dyscrasias with clozapine.

Keywords: Clozapine; Health care access; Health care cost; Health care services; Neutropenia; Safety.