Service use and costs among VA patients with schizophrenia taking risperidone or olanzapine

Objective: The authors compared the changes in health care utilization and costs between a group of patients with schizophrenia who started treatment with risperidone and a group that started treatment with olanzapine. Methods: A retrospective analysis was conducted of patients with schizophrenia who were given an initial prescription for risperidone or for olanzapine between March 1997 and March 1999. The change in utilization and cost of inpatient hospitalizations, outpatient clinic visits, medications, and total health care services from one year before to one year after initiation of treatment for the two groups was compared. Results: The risperidone and olanzapine groups comprised 325 and 285 patients, respectively. Total health care costs declined by $1,536 on average for patients in the risperidone group and increased by $4,217 on average for patients in the olanzapine group after initiation of treatment. The difference was statistically significant, and it was largely due to drug and hospitalization costs. Drug costs for patients in the risperidone group underwent a smaller increase than those for patients in the olanzapine group ($991 versus $1,861). Hospitalization costs decreased by $4,011 for patients in the risperidone group and increased by $1,423 for those in the olanzapine group. Conclusions: Total health care costs declined for patients taking risperidone and increased for patients taking olanzapine after treatment was initiated.