Is Clozapine Underutilized?
Clozapine is an effective drug for treating clients with schizophrenia. It has been shown to be the only medication that will work in many treatment-resistant clients. It is widely accepted as the gold standard for these clients (Cipriani, 2009). It was also recently moved up on the Texas algorithm. However, the FDA mandates clozapine clients be monitored for major side effects caused by this very effective mental health drug. This creates a barrier to prescribing clozapine, because of the additional coordination required of these FDA mandated blood tests, even though clozapine is recognized as one of the most effective mental health drugs. It is also the only antipsychotic that has been proven to reduce the rate of suicide in at risk individuals diagnosed with schizophrenia.
However, we recognize the barriers facing clients and providers are not insignificant. A common barrier amongst providers is the extra administrative work involved in monitoring clients taking clozapine. A provider has extra communication steps involved when prescribing clozapine, such as: arranging the blood draws for the client, coordinating lab results, communicating prescription changes, and reporting the lab results to the clozapine registries. Certainly these barriers impact the utilization of this very effective mental health drug. To overcome these barriers we offer a Clozapine Monitoring Program. In fact, this monitoring program is how Genoa originally started.
Our Clozapine Monitoring Program gives you the ability to provide a remote phlebotomy service to clients taking clozapine, draw their blood for the required blood cell count tests, verify the client is taking their medications properly, and report/monitor the results to ensure the client is not experiencing any side effects. We also enter required lab results into the clozapine registries for the provider. All of this is done at no cost to your agency. The provider no longer needs to be responsible for these extra steps involved in the monitoring of clozapine clients; Genoa takes care of these responsibilities for you. Since clozapine is less expensive than most antipsychotic drugs, using clozapine also lowers overall healthcare expenditures. The average daily cost for clozapine is $5.04. This compares to an average daily cost of Zyprexa at $24.41, Risperdal Consta at $35.39, and Invega Sustenna at $40.98.
Another common barrier is that clients may be resistant to taking the medication due to its inconvenience and side effects. Part of the inconvenience for clients is the FDA mandated blood tests and close monitoring associated with taking this drug. Our program helps to overcome the client barriers because clients no longer have to worry about making their way to a lab for blood work. They also don’t have to feel over monitored by multiple healthcare providers because we can fill their prescriptions and draw their blood. The client gets to know us and their phlebotomist. Without our Clozapine Monitoring Program, clients have to find transportation to a local lab. Clients then have to obtain transportation to the pharmacy to receive their medication, and facilitate the communication of lab results to their provider and the pharmacy.
Additionally, we address the side effects caused by this effective drug. We work with each client to help explain the importance of taking clozapine, and we can help the client overcome this barrier by counseling them on ways to manage the side effects. We also offer specialized adherence programs such as refill reminder calls and convenient packaging. Genoa’s Clozapine Monitoring Program, offers all of these additional services, thereby minimizing the barriers of these additional responsibilities on the welfare of these clients. We also perform all of the necessary leg-work for anyone needing a clozapine prescription transferred from another pharmacy to ours.
Is clozapine being underutilized at your agency? Please contact your Genoa Healthcare Regional Manager if you are interested in learning more about this program.
