The history of clozapine and its emergence in the US market: a review and analysis.
ABSTRACT Clozapine is known as the first 'atypical' medication and is effective in people who have treatment-resistant schizophrenia. Its 1990 emergence in the USA was marked by considerable controversy over its high cost, due in large part to having been both the first new antipsychotic medication to come to market in over a decade and the need for comprehensive safety monitoring within a decentralized health system. This paper traces the history of clozapine's discovery and development in Europe, its part in the 1975 Finnish agranulocytosis scare, and its subsequent volatile emergence in the USA. Analyses examine peripheral forces at the time, particularly the influence of political, corporate, medical and societal forces which shaped its market course.
Journal of Progressive Human Services 05/2014; 25(2):75-97. DOI:10.1080/10428232.2014.898240
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ABSTRACT: We present two new findings based on annual antipsychotic US prescribing data from IMS Health on 2867 psychiatrists who wrote 50 or more prescriptions in 2007. First, many of these psychiatrists have prescription patterns that are statistically significantly different than random draws from national market shares for prescriptions by psychiatrists. For example, many have prescription patterns that are significantly more concentrated than such draws. Second, among psychiatrists who are the most concentrated, different prescribers often concentrate on distinct drugs. Motivated by these two findings, we then construct a model of physician learning-by-doing that fits these facts and generates two further predictions: both concentration (on one or a few drugs) and deviation (from the prescription patterns of others) should be smaller for high-volume physicians. We find empirical support for these predictions. Furthermore, our model outperforms an alternative theory concerning detailing by pharmaceutical representatives. Copyright © 2014 Elsevier B.V. All rights reserved.Journal of Health Economics 12/2014; 40C:26-39. DOI:10.1016/j.jhealeco.2014.11.003 · 2.25 Impact Factor