Modelling the impact of clozapine on suicide in patients with treatment-resistant schizophrenia in the UK

Background: Schizophrenia is a major cause of suicide, and symptoms characteristic of treatment-resistant disease are strong risk factors. Clozapine reduces symptoms in 60% of such patients and significantly decreases the risk of suicide. Aims: To model the impact of increased clozapine prescribing on lives saved and resource utilisation. Method: A model was built to compare current levels of clozapine prescribing with a scenario in which all suitable patients with treatment-resistant schizophrenia received clozapine. Results: It was estimated that an average of 53 lives could be saved in the UK each year. If clozapine is cost-neutral, the cost per life-year saved is £5108. If clozapine achieves a 10% reduction in annual support costs, the net saving is £8.7 million per annum. An average of 167 acute beds would be freed each year. Conclusions: The use of clozapine in treatment-resistant schizophrenia saves lives, frees resources and is cost-effective.