Generic does well against newer CNS drugs, gov’t. study finds
An older drug performed as well as all but one of the newer, more expensive ones used to treat schizophrenia in a government-backed study that could have effects on treatment and reimbursement.
The study of 1,493 people with the illness, which will appear in the New England Journal of Medicine this week, is by far the largest, most rigorous head-to-head trial of atypical antipsychotics without significant drug industry funding, reported The New York Times.
Researchers looked at generic drug perphenazine and four of the newer atypical antipsychotics, finding that all five were effective in dulling the symptoms of the illness. Yet modest doses of the generic were not as likely to cause neurological symptoms like shaking, researchers found.
The branded drugs were AstraZeneca's Seroquel (quetiapine), Eli Lilly's Zyprexa (olanzapine), Johnson & Johnson's Risperdal (risperidone) and Pfizer's Geodon (ziprasidone). These drugs comprise 90 percent of the $10-billion antipsychotic market, noted The Wall Street Journal.
The findings may have significant implications for schizophrenia treatment and could give pause to private insurers. In addition, some Medicaid programs could use the findings to deny patients access to more expensive drugs that may be more effective for them, a policy analyst told the Times.
Each drug was judged by how long patients continued therapy. Nearly three-quarters of subjects stopped taking the drugs they were given within 18 months, because of side effects or poor control of symptoms, according to the Journal.
Zyprexa was significantly more effective than the other drugs at controlling symptoms, but it showed a higher risk of serious side effects, like weight gain--a class concern emerging in recent years. Still, patients stayed on Zyprexa the longest, a median of 9.2 months. The next in line was the generic at 5.6 months, followed by Risperdal (4.8 months), Seroquel (4.6 months) and Geodon (3.5 months).