Second-generation antipsychotics: Cost-effectiveness, policy options, and political decision making

Robert A. Rosenheck, Douglas L. Leslie, Jalpa A. Doshi

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations


The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and other recent research suggest that second-generation antipsychotics other than clozapine may offer few, if any, advantages over first-generation antipsychotics, especially agents of intermediate potency. Thus the newer agents are not likely to generate sufficient benefit to justify their $11.5 billion annual cost. Policy approaches for containing drug costs are available and could improve cost-effectiveness by encouraging that second-generation antipsychotics be prescribed more selectively, such as only when clearly indicated. However, restrictions on either drug availability or physician choice are vigorously opposed by professional and consumer advocacy groups as well as by industry, and excessively restrictive approaches could unintentionally reduce access to beneficial treatments. Interventions that directly reduce second-generation antipsychotic prices would increase access for consumers but are inconsistent with broad opposition to government price regulation in the United States. High expenditures on these medications are thus likely to continue without concomitant gains for public health.

Original languageEnglish (US)
Pages (from-to)515-520
Number of pages6
JournalPsychiatric Services
Issue number5
StatePublished - May 2008

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health


Dive into the research topics of 'Second-generation antipsychotics: Cost-effectiveness, policy options, and political decision making'. Together they form a unique fingerprint.

Cite this