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The British Journal of Psychiatry (2003) 182: 505-508
© 2003 The Royal College of Psychiatrists

Modelling the impact of clozapine on suicide in patients with treatment-resistant schizophrenia in the UK

ANDY DUGGAN, BA and JULIET WARNER, BA

Abacus International, Bicester

MARTIN KNAPP, PhD and ROBERT KERWIN, FRCPsych

Institute of Psychiatry, London, UK

Correspondence: Juliet Warner, Abacus International, 3–4 Market Square, Bicester OX26 6AA, UK

Declaration of interest This project was sponsored by Novartis Pharmaceuticals UK Ltd.

Background Schizophrenia is a major cause of suicide, and symptoms characteristic of treatment-resistant disease are strong risk factors. Clozapine reduces symptoms in 60% of such patients and significantly decreases the risk of suicide.

Aims To model the impact of increased clozapine prescribing on lives saved and resource utilisation.

Method A model was built to compare current levels of clozapine prescribing with a scenario in which all suitable patients with treatment-resistant schizophrenia received clozapine.

Results It was estimated that an average of 53 lives could be saved in the UK each year. If clozapine is cost-neutral, the cost per life-year saved is £5108. If clozapine achieves a 10% reduction in annual support costs, the net saving is £8.7 million per annum. An average of 167 acute beds would be freed each year.

Conclusions The use of clozapine in treatment-resistant schizophrenia saves lives, frees resources and is cost-effective.


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