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Wednesday, August 4, 1999 Published at 22:46 GMT 23:46 UK


Health

Schizophrenics 'denied new drugs'

Side effects can lead to stigmatisation

Schizophrenics are being denied the most up-to-date drugs because they cost too much, a report has claimed.


BBC Social Affairs Editor Niall Dickson: "The side effects of the new drugs are much less severe"
The report, from the National Schizophrenia Fellowship (NSF), found that 80% of psychiatrists have faced restrictions in drug prescribing, and 53% of those said the restrictions were financial.

The fellowship said that this meant patients were being forced to take old-style drugs with "horrific" and potentially permanent side effects such as shaking, restlessness, a mask-like face and muscle spasms.

Is Cost a Factor II was compiled by Gary Hogman, the fellowship's head of policy and campaigns, and David Taylor, chief pharmacist at the Maudsley Hospital, a leading centre for mental health care in London.

Continued research

The same authors produced a report last November highlighting how health authorities ration what many doctors consider the most effective treatments

The new report points to side effects of the old-style drugs, in particular, tardive dyskinesia.

This causes the shaking, facial tics and muscle spasms that many people associate with schizophrenia, even though the treatment is to blame.

While some movement disorders are associated with untreated schizophrenia, the most extreme and uncontrollable ones are caused by the drugs, the NSF said.

Newer treatments do not cause these problems, but they are more expensive - which deters health authorities from prescribing them, the report said.

Stigma

However, the side effects can add to the burden of coping with the disease and social stigmatisation, the NSF said.

Cliff Prior, chief executive of the NSF, said the only chance many patients had to overcome schizophrenia depended on being given the best available treatments.

"This is a shocking report. People with schizophrenia are being left to rot on toxic drugs that have appalling side effects," he said.

"Their lives are being ruined twice over - by illness and by the drugs used to treat it."

A spokeswoman for the Association of the British Pharmaceutical Industry said the organisation wanted the government to allow doctors to choose what they thought was the most appropriate treatment.

"Any patient deserves to get the best treatments, and in the long term the cost savings that are made by using these new medicines and avoiding hospital admission or lengthy social care," she said.

"You have to look at medicines in the broader picture."

Tough choices

Dr Cosmo Hallstrom, a psychiatrist and medical director of the Charter Clinic in London, said: "These new drugs do have fewer side effects."

However, doctors and managers faced difficult choices when it came to deciding to adopt a new drug.

"Before you rush on with a new treatment you have to stop and ask if the costs are justified.

"The health authority might say, 'well, you can have these new drugs, but that might mean we can't open up that new ward'.

"You've got to decide what's more valuable."

'A job for NICE'

A spokeswoman for the Department of Health said not all drugs were appropriate in all settings and some required hospital monitoring.

As such it was up to individual clinicians to decide what was the most appropriate drug.

However, she declined to comment on whether clinicians were having their judgement undermined by financial considerations.

"It's the sort of thing that the National Institute for Clinical Excellence (NICE) and the Commission of Health Improvement have been set up to look at," she said.

NICE was launched on 1 April to examine the cost and clinical effectiveness of treatments and drugs.

Health Secretary Frank Dobson has yet to refer any treatments to the institute.



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Association of the British Pharmaceutical Industry

National Schizophrenia Fellowship

Department of Health

Royal College of Psychiatrists


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