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Mental Health Advocates: Cost of New Wonder Drug Too High

July 13, 1990

PITTSBURGH (AP) _ Mental health advocates are hailing a new drug for acute schizophrenia but criticizing its pricetag - $750 per month per patient.

Groups attending a weeklong convention on psychiatric treatment want Sandoz Pharmaceuticals Corp. to provide more information on clozapine’s cost. They also urged state hospitals to buy more.

The National Alliance for the Mentally Ill has adopted the same position.

″We’re hearing what sound like testimonials at church revivals on the effects of the drug,″ said J. Benedict Centifanti, deputy director of Pennsylvania Protection and Advocacy Inc., a support group for psychiatric patients.

Clozapine reduces emotional disturbances and thought disorders in schizophrenics who haven’t responded to conventional treatment, said Sandoz, which introduced it in February.

″In some cases recovery is quite dramatic,″ said Barbara Gordon, research director for the state Office of Mental Health. ″In others it’s not so dramatic, but even they are showing improvement.″

Unlike other drugs prescribed for schizophrenia, such as thorazine and prolixin, clozapine doesn’t cause involuntary facial tremors known as tardive dyskinesia, an irreversible condition in some cases.

″When you take one of those drugs you are rolling the dice,″ said Dr. Janice Guidotti, who held a workshop Thursday at Duquesne University.

The workshop was part of a five-day convention attended by 1,000 current and former mental patients and their advocates, whose goals include getting rid of a perceived stigma associated with psychiatric treatment and advancing a nationwide civil rights movement for mental patients.

Sandoz Pharmaceuticals of East Hanover, N.J., said part of the reason for clozapine’s high cost is the need for patients to undergo weekly blood tests to check for a potentially deadly side effect - a reduction in white blood cell count.

The company estimates 5,000 patients in public and private hospitals in the United States take clozapine. Sandoz Pharmaceuticals estimated up to 2 percent of patients taking the drug could develop the side effect.

The price of the drug should drop when more psychiatrists prescribe it, said Dr. Gilbert Honigfeld, a Sandoz spokesman.

At a workshop Thursday, Centifanti cited the case of James Angliss, a patient at Western State Hospital in Steilacoom, Wash., who sued for the right to take clozapine. Administrators withheld it because of cost and potential liability.

The case is believed to be the first in the United States involving clozapine, Centifanti said.

A jury awarded Angliss $600,000 and his mother $60,000 after he was forced to take another drug and developed tardive dyskinesia. The hospital has appealed the case.

Pennsylvania will spend $2 million this fiscal year to treat schizophrenics with clozapine in state hospitals, enough for about 220 patients. Gordon said there are 4,500 schizophrenics among 7,000 state hospital patients.

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