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Aims and Methods  The aim of this study was to examine the impact of prescribing clozapine for a cohort of patients with treatment-resistant schizophrenia in a local clinical service. Information was collected about the use of health care resources in the six months before and the six months after starting clozapine. Information was also recorded as to the effect of clozapine on daily living skills and overall clinical improvement.    Results  The introduction of clozapine was associated with clinical befefits both in terms of overall clinical improvement and daily living skills. The introduction of clozapine was cost neutral in the first six months when taking into account both drug costs and total health care costs. The reduction in hospital bed usage did not occur untill the third and fourth year following the introduction of clozapine.    Clinical Implications  Although the drug costs of clozapine are higher than the use of traditional neuroleptics for treatments-resistant schizophrenia, the immediate overall costs of introducing colzapine were no higher than before the drug was introduced. Saving in hospital bed usage did not occur until after a period of hehabilitation. It is our impression that the clinical improvement brought about by clozapine enabled patients to benefit from the rehabilitation service to a greater extent than before the drug was started.

Outcome of clozapine treatment for patients with treatment-resistant schizophrenia in a local clinical service