Post by Mary on Dec 3, 2006 12:09:27 GMT -5
By Julie Steenhuysen and Kim Dixon
CHICAGO (Reuters) - A new study finds that an older antipsychotic drug is cheaper and equally effective for some patients with schizophrenia, sending makers of newer drugs scrambling to defend their products on Friday.
The American Journal of Psychiatry study concluded that the older, first-generation antipsychotic drug perphenazine was less expensive and as effective as newer medications such as AstraZeneca Plc's Seroquel and Eli Lilly and Co.'s Zyprexa.
Funded by the U.S. National Institutes of Health, the $42.6 million study suggests doctors should consider the use of older antipsychotics as a first choice for patients with schizophrenia, a group of psychotic diseases marked by delusions and hallucinations.
"There could be a very useful role -- from a clinical and cost-effectiveness standpoint -- for greater utilization of some older-generation medications," said Dr. Jeffrey Lieberman, a psychiatrist at Columbia University Medical Center and the study's lead author.
Currently, the lion's share of antipsychotic prescriptions -- more than 90 percent -- are written for second-generation drugs, which also include Johnson & Johnson's Risperdal, known by the chemical name risperidone, and Pfizer Inc.'s Geodon, also known as ziprasidone.
The brand name drugs cost about $200 to $300 per month, or 40 to 50 percent more than the older generic drugs, according to the study.
Lieberman said physicians should not automatically exclude perphenazine and other older drugs from the range of options.
"It's not like you are practicing antiquated medicine by using the older medications," he said. "These results will enable doctors to be aware of the cost considerations when they are making their choice in treatments."
Introduced in the 1990s, second-generation antipsychotic drugs now account for some $10 billion in U.S. sales, a bill paid largely by the government.
Makers of newer antipsychotic drugs downplayed the findings, criticizing the study's design and saying that different medications will work for different patients.
Arthur Lazarus, senior director of clinical research at AstraZeneca, warned that older drugs were subject to serious long-term side effects, such as tardive dyskinesia (TD), a movement disorder characterized by facial grimacing, tongue protrusion, rapid eye blinking and other involuntary motion.
"Why expose them to a lifetime of therapy when the risk of TD with these drugs is approximately 50 percent?" he said.
Shares of AstraZeneca fell as much as 2.2 percent on fears that demand for Seroquel, known by the chemical name quetiapine, would be hurt. The drug is the Anglo-Swedish group's second-biggest seller, with 2005 sales of $2.8 billion, and is the most prescribed U.S. treatment of its type.
The newer antipsychotic drugs, however, are associated with their own set or risks, including weight gain and an increased risk of diabetes, Lieberman said.
Lilly said the study found its drug -- Zyprexa or olanzapine -- was the most cost effective among the four newer-generation drugs studied.
The company said the study's high dropout rate limited the collection of long-term data, and suggested it not be used to limit access to newer drugs, a sentiment echoed by The National Alliance on Mental Illness, a patient group.
Most anti-psychotic drugs prescribed in the United States are paid by government agencies such as Medicaid, the state-federal health insurance program for the poor, because the illness often renders people unable to work.
"There is a growing anxiety in the community when we see studies like this, that it will give Medicaid directors permission" to add restrictions to drugs, said Ken Duckworth, medical director at the alliance.
Lieberman said he and his research colleagues hope policymakers will exercise restraint.
"It is our great hope that this not come at the expense of restricting the access and choice that patients and doctors have," he said.
Shares of Lilly fell 0.2 percent on the New York Stock Exchange, while Pfizer's shares rose 1.4 percent after an upbeat analyst meeting on Thursday.
CHICAGO (Reuters) - A new study finds that an older antipsychotic drug is cheaper and equally effective for some patients with schizophrenia, sending makers of newer drugs scrambling to defend their products on Friday.
The American Journal of Psychiatry study concluded that the older, first-generation antipsychotic drug perphenazine was less expensive and as effective as newer medications such as AstraZeneca Plc's Seroquel and Eli Lilly and Co.'s Zyprexa.
Funded by the U.S. National Institutes of Health, the $42.6 million study suggests doctors should consider the use of older antipsychotics as a first choice for patients with schizophrenia, a group of psychotic diseases marked by delusions and hallucinations.
"There could be a very useful role -- from a clinical and cost-effectiveness standpoint -- for greater utilization of some older-generation medications," said Dr. Jeffrey Lieberman, a psychiatrist at Columbia University Medical Center and the study's lead author.
Currently, the lion's share of antipsychotic prescriptions -- more than 90 percent -- are written for second-generation drugs, which also include Johnson & Johnson's Risperdal, known by the chemical name risperidone, and Pfizer Inc.'s Geodon, also known as ziprasidone.
The brand name drugs cost about $200 to $300 per month, or 40 to 50 percent more than the older generic drugs, according to the study.
Lieberman said physicians should not automatically exclude perphenazine and other older drugs from the range of options.
"It's not like you are practicing antiquated medicine by using the older medications," he said. "These results will enable doctors to be aware of the cost considerations when they are making their choice in treatments."
Introduced in the 1990s, second-generation antipsychotic drugs now account for some $10 billion in U.S. sales, a bill paid largely by the government.
Makers of newer antipsychotic drugs downplayed the findings, criticizing the study's design and saying that different medications will work for different patients.
Arthur Lazarus, senior director of clinical research at AstraZeneca, warned that older drugs were subject to serious long-term side effects, such as tardive dyskinesia (TD), a movement disorder characterized by facial grimacing, tongue protrusion, rapid eye blinking and other involuntary motion.
"Why expose them to a lifetime of therapy when the risk of TD with these drugs is approximately 50 percent?" he said.
Shares of AstraZeneca fell as much as 2.2 percent on fears that demand for Seroquel, known by the chemical name quetiapine, would be hurt. The drug is the Anglo-Swedish group's second-biggest seller, with 2005 sales of $2.8 billion, and is the most prescribed U.S. treatment of its type.
The newer antipsychotic drugs, however, are associated with their own set or risks, including weight gain and an increased risk of diabetes, Lieberman said.
Lilly said the study found its drug -- Zyprexa or olanzapine -- was the most cost effective among the four newer-generation drugs studied.
The company said the study's high dropout rate limited the collection of long-term data, and suggested it not be used to limit access to newer drugs, a sentiment echoed by The National Alliance on Mental Illness, a patient group.
Most anti-psychotic drugs prescribed in the United States are paid by government agencies such as Medicaid, the state-federal health insurance program for the poor, because the illness often renders people unable to work.
"There is a growing anxiety in the community when we see studies like this, that it will give Medicaid directors permission" to add restrictions to drugs, said Ken Duckworth, medical director at the alliance.
Lieberman said he and his research colleagues hope policymakers will exercise restraint.
"It is our great hope that this not come at the expense of restricting the access and choice that patients and doctors have," he said.
Shares of Lilly fell 0.2 percent on the New York Stock Exchange, while Pfizer's shares rose 1.4 percent after an upbeat analyst meeting on Thursday.