Eli Lilly and Company       
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Hospitalization Savings Estimated to Offset Medication Costs

People with schizophrenia treated with olanzapine are less likely to
be hospitalized and also spend significantly fewer days in the
hospital than patients treated with risperidone, new data show.
Furthermore, fewer hospitalized days resulted in an annual
hospitalization cost savings of $2,500 per olanzapine-treated patient,
per year. The findings were presented at the 55th Institute on
Psychiatric Services meeting in Boston. The data were collected as
part of a landmark three-year "real world" study of people with
schizophrenia, called the Schizophrenia Care and Assessment Program
(SCAP) that evaluated available schizophrenia treatments.

"Hospitalization represents by far the largest expenditure associated
with the treatment of schizophrenia, and it's usually something
patients want to avoid if they possibly can. A medication that can
help clinicians keep people out of the hospital offers a big advantage
to patients, as well as caregivers," said Jeff Swanson, Ph.D.,
associate professor of Psychiatry & Behavioral Sciences at Duke
University Medical Center, and a SCAP investigator.

Unlike a traditional clinical trial, SCAP was a longitudinal
observational study designed to understand and improve the treatments
currently provided to schizophrenia patients in usual care settings
(e.g., employment, mental and physical functioning, housing and
substance abuse). Sponsored by Eli Lilly and Company, SCAP is one of
the largest naturalistic studies ever to be conducted in the United
States, consisting of 2,400 patients located at multiple centers
across the country.

Key Findings

-- Olanzapine-treated patients had lower hospitalization rates
compared to patients treated with risperidone (14.4 percent vs. 24.1
percent).

-- Olanzapine-treated patients were hospitalized for significantly
fewer days compared to patients treated with risperidone (9.9 days vs.
14.5 days).

-- In terms of economic cost, the mean annual group difference of 4.6
days in the olanzapine group translates to a cost savings of $2,502
per patient in hospitalization costs (at $556 per day).

-- The median time to first psychiatric hospitalization for patients
treated with olanzapine was 1.8 times longer than for patients treated
with risperidone (94 days vs. 173 days).

-- During the first six months of treatment, patients treated with
olanzapine had 3.9 fewer hospitalization days than the risperidone
group.

Study Design

In this non-randomized prospective study, patients who were initiated
on olanzapine (N=159) were compared with patients who were initiated
on risperidone (N=112) on the one-year risk of psychiatric
hospitalization. Patients who were diagnosed with schizophrenia,
schizoaffective disorder, or schizophreniform disorder, received
olanzapine or risperidone for at least one year following initiation,
and did not receive either treatment in the 60 days prior to
initiation. The primary outcome measure was the number of psychiatric
hospitalization days during the year. A generalized Linear Model was
used to compare medication groups on the average number of
hospitalization days after log transformation. A Logistic Model was
used for comparing medication groups on the percent of patients who
were hospitalized during the one year following initiation.
Kaplan-Meier survival analysis was used to compare medication groups
on the time to first psychiatric hospitalization.

"An observational study such as SCAP provides an innovative research
model because it evaluates and demonstrates the effectiveness of a
treatment in a real-world setting," said Marvin Swartz, M.D.,
professor and head of the Division of Social and Community Psychiatry
at Duke University Medical Center, and a SCAP investigator. "This type
of outcomes data offers unique advantages that differentiate it from
data that are based on randomized clinical trials."

About Schizophrenia

Schizophrenia is a severe and debilitating psychosis often
characterized by acute episodes of delusions (false beliefs that
cannot be corrected by reason), hallucinations (usually in the form of
non-existent voices) and long-term impairments such as diminished
emotion, lack of interest and depressive signs and symptoms. It is
usually associated with a disruption in social and family
relationships.

Schizophrenia is the most common severe mental illness. More than two
million American adults have the disease, with more than 100,000 new
cases reported each year. Symptoms of schizophrenia usually begin to
appear in the teenage years or early to mid-twenties.

Olanzapine Background

Olanzapine is indicated in the United States for the treatment of
schizophrenia, the short-term treatment of acute manic episodes
associated with bipolar disorder and for the long-term therapy and
maintenance of treatment response of schizophrenia. Since olanzapine
was introduced in 1996, it has been prescribed to 12 million people
worldwide.

The most common treatment-emergent adverse event associated with
olanzapine in placebo-controlled, short-term schizophrenia and bipolar
mania trials was drowsiness. Other common events were dizziness,
weight gain, personality disorder (COSTART term for nonaggressive
objectionable behavior), constipation, akathisia, postural
hypotension, dry mouth, asthenia, dyspepsia, increased appetite, and
tremor.

A small number of patients in premarketing trials experienced
asymptomatic elevations of hepatic transaminase; none of these
patients developed jaundice. Periodic assessment of transaminases is
recommended in patients with significant hepatic disease.

Prescribing should be consistent with the need to minimize the risk of
neuroleptic malignant syndrome, tardive dyskinesia, seizures, and
orthostatic hypotension.

Hyperglycemia and diabetes mellitus--Hyperglycemia, in some cases
associated with ketoacidosis, coma, or death, has been reported in
patients treated with atypical antipsychotics including olanzapine.
Assessment of the relationship between atypical antipsychotic use and
glucose abnormalities is complicated by the possibility of an
increased background risk of diabetes mellitus in patients with
schizophrenia and the increasing incidence of diabetes mellitus in the
general population. The available data are insufficient to provide
reliable estimates of differences in hyperglycemia-related adverse
event risk among the marketed atypical antipsychotics. All patients
taking atypicals should be monitored for symptoms of hyperglycemia.
Persons with diabetes who are started on atypicals should be monitored
regularly for worsening of glucose control; those with risk factors
for diabetes should undergo baseline and periodic fasting blood
glucose testing. Patients who develop symptoms of hyperglycemia during
treatment should undergo fasting blood glucose testing.

About Eli Lilly and Company

Lilly, a leading innovation-driven corporation, is developing a
growing portfolio of best-in-class pharmaceutical products by applying
the latest research from its own worldwide laboratories and from
collaborations with eminent scientific organizations. Headquartered in
Indianapolis, Ind., Lilly provides answers - through medicines and
information - for some of the world's most urgent medical needs.
Additional information about Lilly is available at www.lilly.com.