Influenza del trattamento della schizofrenia con neurolettici tipici o olanzapina sui costi sanitari e sugli outcomes lavorativi

The aim of the present study was to evaluate the global treatment cost of schizophrenia with olanzapine or typical neuroleptics, according to Local Health Care Unit point of view. This analysis was performed through naturalistic observation of a cohort of schizophrenic patients referring to Ascoli Piceno ASL Department of Mental Health during 4 years (2001-2004). During year 2003, investigators have identified a cohort of patients who were undergoing treatment switch from typical neuroleptics to olanzapine. These patients, after the switch, are observed prospectively for the next 2 years and retrospectively for the last 2 years of treament. This method allow us to collect data about 4 years of treatment: 2 years of typical neuroleptic treatment followed by 2 years of olanzapine treatment. The present work is presenting the analysis of the first 3 years of observation. The results of our analysis are demonstrating that olanzapine treatment, through a better patient-physician alliance and with rehabilitative activities, allow lower total medical costs for the treatment of schizophrenia than typical neuroleptics. The higher acquisition cost of olanzapine versus typical neuroleptics was compensated by less hospitalizations and territorial medical interventions. During olanzapine treatment patients followed more rehabilitative activities (+71,26%,

Chi sei? Sé, soggetto, persona

E' intatta l'urgenza di rilanciare l'antica insidia adombrata nella domanda della Sfinge a Edipo e nel cui enigma si intrecciano la pluralità delle andature con l'identità ricercata al prezzo della stessa vita. E chiedere di nuovo: chi sei? - nei registri di posture diverse, ma sempre almeno doppie o triple o quadruple, come quelle evocate dall'indovinello antico. Il volume è il risultato di un percorso di ricerca condotto da un gruppo di filosofi, psicoanalisti e psichiatri intorno alla questione dell'identità

Olanzapine versus typical neuroleptics for schizophrenia: evaluation of social and economic costs

An important number of publications is reporting results from health outcomes studies comparing atypical antipsychotics (AA) with typical neuroleptics (TN) over 1 year of observation. Our study has prolonged the period observation of the economical and social outcomes to 4 years: 31 patients with schizophrenia were observed retrospectively during two years of TN treatment and then followed during 2 more years of olanzapine treatment after naturalistic switch. The results show a general reduction of health care interventions (territory and hospital) during the olanzapine treatment period. Global costs during olanzapine treatment were lower than during TN treatment (10506 euros with TN vs 6193 euros with olanzapine over 2 years). The social outcome, measured through the registration of the number of working days in the two periods of the study (retrospective with TN and prospective with olanzapine), was better during olanzapine treatment, probably due to increased patient compliance to the rehabilitative activities offered by the Department of Mental Health. In our experience, olanzapine appeared to dominate TN treatment, as its higher acquisition costs were offset by the reduction of territorial and nosocomial health care interventions over two years of observation, and associated with higher involvement in rehabilitative and social activities