By treating many studies as one, the individual attributes of a given treatment for a specific sub-group of the population is easily overlooked, or lost in the wider 'pooling' of data. Specific, well-designed trials are needed to investigate the benefits of these treatments in groups of patients with specific symptom profiles. The cost-effectiveness of atypical antipsychotics, which are substantially more expensive than conventional drugs, has been in the spotlight following reports that some healthcare trusts simply can't afford to use the atypicals. It has been argued that the increased cost of treatment is offset by the reduced incidence of hospital admissions and relapse in people treated with atypicals. However, individual clinical trials rarely reflect the wider complexity of issues encountered in the clinical setting, and there is currently insufficient evidence to definitively support or refute this 'pay now, don't pay later' rationale.
Studies are underway to try to assess the cost-effectiveness of atypical antipsychotics.
Susie Morrow, clinical assessor for the CUtLASS project at the Institute of Psychiatry, issued a statement in response to the Geddes study. References Geddes J, Freemantle N, Harrison P et al.