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Friday, November 20, 1998 Published at 07:53 GMT


Health

Mentally ill lose out on new drugs

The mentally ill are being deprived of the drugs they need, the survey says

A survey has found that nearly half of health authorities cannot afford modern drug treatments for people suffering from schizophrenia.

As a result, thousands of patients are being given old, less effective drugs which have serious side-effects.


Social Affairs Editor Niall Dickson: "New drugs could save over 100 lives each year by reducing suicides"
The National Schizophrenia Fellowship (NSF) and the Maudsley Hospital say many health authorities are rationing new, more effective drugs.

In the last eight years, five new types of anti-psychotic drugs have been introduced in the UK.

A survey of 60 health authorities found that 45% did not fund clozapine, 57% did not pay for olanzapine and 58% did not fund resperidone in their hospitals.

Up to 45% also did not recommend that GPs prescribe the drugs - known as atypicals because they have fewer side effects.

Clozapine has been found to help two thirds of patients for whom older drugs do not work, says the NSF.

Facial tics

The atypicals have an advantage over older drugs in that they are less likely to produce the Parkinson's-like symptoms associated with them, such as uncontrollable muscle spasms and facial tics.

They also provoke fewer symptoms such as breast growth and impotence.

Mental health workers say people tend to associate the symptoms with chronic mental illness such as schizophrenia rather than with the drugs, increasing the stigma attached to the illness.

However, the older drugs are much cheaper than the new ones.

The NSF says a yearly course of the new atypical drugs can cost up to £5,800 per person, compared with £100 a person for a course of the old ones.

But they argue that the drugs allow patients to be treated in the community, saving on hospital costs. Hospital beds can cost up to £50,000 a year.

Peer pressure

The NSF thinks part of the reason for the rationing is peer pressure - health workers say they are pressurised not to 'rock the boat' by cash-strapped colleagues.

Another reason is health authorities' emphasis on costs over medical benefits, they say. They accuse many health authorities of having league tables of medication costs.

The NSF also identifies the use of terms such as "priority setting" to disguise rationing.


[ image: Hospitals are being banned from prescribing the new drugs]
Hospitals are being banned from prescribing the new drugs
David Taylor, the Maudsley's Chief Pharmacist, said: "The restriction on the use of new drugs in psychiatry is nothing but a scandal - a scandal which for once has gone virtually unreported.

"Central government needs to be made aware of underfunding for those with serious mental illness."

Head of Research and Communications at the NSF, Gary Hogman, said the government tended to stress the fact that some mentally ill patients do not take their medication.

He said the NSF's experience was the opposite. People were desperate to obtain the best treatment, but were being denied it.

"This survey confirms the scandalous refusal of some health authorities to meet people's needs for modern effective treatments," he said.

"The simple fact is that this kind of rationing for new cancer or heart drugs would not be allowed - there would be a public outcry."

Discontinued medication

Mental health charity Sane said the findings echoed its own research.

"It is definitely based on cost," said a spokeswoman for Sane. "There is a very, very big difference in cost, but we believe the benefits to patients outweigh the costs."

A recent report by Dr Jonathan Hellewell, consultant psychiatrist at Trafford General Hospital in Manchester, found that the side-effects associated with older anti-psychotic drugs were a big factor in patients deciding to discontinue their medication.

Mental health workers say this can lead to patients being at an increased risk of breakdown and relapse.

According to the Health Education Authority (HEA), around one in 100 people in the UK will experience an episode of schizophrenia in their lifetime.

A quarter will recover fully, but up to 15% will have enduring problems.

It is thought that schizophrenia is triggered by a mixture of social and personal factors, including stress, taking illegal drugs and genetic causes.

The HEA says the cost of treating schizophrenia is around £2.6bn a year, including loss of working hours.



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National Schizophrenia Fellowship

Health Education Authority


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