Clozapine use in an early psychosis intervention program: Clinical recovery and cost effectiveness

Poster A118, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Gordon Shymko1, Terina Grace1, Flavie Waters1, Chelsey Williams, Nicole Jolly; 1University of Western Australia

Background: Early intervention models of care aim to improve access and reduce duration of untreated psychosis and identify effective treatment to improve clinical and functional recovery outcomes for young people. Clozapine has been hailed as an effective antipsychotic for treatment-resistant schizophrenia, but its use in early psychosis remains largely unexplored. Aim: This study examined the use of Clozapine by Black Swan Health in an early intervention model and effectiveness in reducing mental health admissions and associated costs. Methods: A longitudinal case study approach which examines the profile of service utilisation of young people at hYEPP prescribed Clozapine. Mental health inpatient admissions pre- and post-Clozapine initiation were compared. Results: Ten young people were prescribed Clozapine in 2016 and 2017 (median dose = 260 mg, range 200-500 mg). Eight young people were compliant (5 males, aged 18-24). Prior to Clozapine, the number of inpatient admissions averaged 3.6 (range 1-9 admissions), and inpatient days averaged 137.5 (range 11-379 days). Costs of inpatient admissions in the 12-months prior to Clozapine were estimated at $177,300 pp. Since Clozapine commencement, there had been no further inpatient re-admissions, representing a 12-month saving of approximately $1,418,400 in acute hospitalisation costs across 8 young people. The other 2 non-compliant young people had further re-admissions after the discontinuation of Clozapine (2 and 5 respectively), incurring an additional $252,000 in healthcare utilisation costs in a 12-month period. Conclusions: Results show early introduction of Clozapine enhance and optimise recovery by reducing the rate of mental health admissions and healthcare costs.

Topic Area: Psychopharmacology

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