CUtLASS: Changing attitudes and prescribing practice: cost effectiveness of first versus second generation antipsychotic drugs in people with schizophrenia

Impact: Health impacts, Economic impacts


Schizophrenia affects 1% of people, usually leading to lifelong disability. Antipsychotic drugs, first developed in the 1950s, are the mainstay of treatment. A new class of second generation antipsychotic (SGA) drugs was introduced in the 1990s. SGA drugs cost 20-30 times more than first generation (FGA) drugs. Research at the University of Manchester (UoM) between 1999 and 2003 demonstrated that, against globally-held expectations, the heavily-promoted SGA drugs (global market value 2008 $18.2bn – Datamonitor) had no advantages in effectiveness, tolerability, or patient preference over more cost-effective FGA drugs. The results have informed clinical guidelines in the UK (NICE), USA, Canada and other countries, with evidence of change in prescribing practice.
Impact date2014
Category of impactHealth impacts, Economic impacts
Impact levelBenefit