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To the Editor: Dr Rosenheck and colleagues¹ concluded that the atypical antipsychotic drug olanzapine was unlikely to be more cost-effective than haloperidol.² Furthermore, the literature suggests that there is no significant difference between these atypical drugs in terms of either efficacy or effectiveness.³ Atypical antipsychotic drugs differ among themselves and from conventional antipsychotics in terms of their tendency to produce endocrinological adverse effects.^3-4 The study by Rosenheck et al found that a significant portion of the added costs of olanzapine was related to weight gain, an endocrine adverse effect. Thus, the authors' results suggest that future cost-effectiveness analyses of atypical antipsychotics should take endocrinological adverse effects into account.

We doubt that it is possible to measure quality of life without considering adverse effects, some of which may also be associated with significant monetary costs. Given that atypical antipsychotic drugs have similar efficacy and effectiveness, we suspect that future decisions about . . . [Full Text of this Article]

Mo Amin, BSc, MSc, PhD
moa@ccohta.ca

Vijay S. Shukla, BPharm, MSc, PhD
Canadian Coordinating Office for Health Technology Assessment
Ottawa, Ontario

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