CLOZAPINE ELIGIBILITY AMONG STATE-HOSPITAL PATIENTS

Connecticut State Hospital's entire resident population (n = 1,300) wa s screened on an arbitrary target day to determine eligibility for clo zapine. Sixty percent of 803 patients with schizophrenia or schizoaffe ctive disorder diagnoses met Food and Drug Administration (FDA)approve d criteria for clozapine use as judged by review of past medication tr ial records and by the responsible physician. Eighty-eight percent of these patients were medically cleared, and of those cleared, 63 percen t agreed to clozapine treatment. Of the patients who began a clozapine trial, 76 percent were still taking the drug 12 months later. Prelimi nary findings from a randomized trial of clozapine versus usual care ( n = 227) indicate that discharge rates associated with clozapine and u sual care do not differ. Once discharged, however, patients assigned t o clozapine are less likely to be readmitted. Hence, clozapine may be more cost-effective than usual care. However, before savings can be re alized, State governments will have to make up-front investments of ap proximately $140 million simply to give patients hospitalized on a sin gle day a year's access to clozapine.