Aripiprazole (trade name abilify) is an antipsychotic drug, licensed to market itself as indicated in the treatment of schizophrenia, mania and the control of agitation and disturbed behaviour in schizophrenia.
The BNF shows that a month's supply of aripiprazole 30mg has a reference cost of £191.47
Now, a drug cost of £2297.64 a year isn't actually that huge. Compare it to the cost of an admission to hospital and it's clear that keeping someone with manic/schizophrenia well for that amount is great for the patient and great for the NHS. Sure, there're medical costs of assessment and prescribing, pharmacist costs in dispensing, but actually it's still much better for the patient not to relapse and much more cost effective to spend staff/drug costs on this, than have an admission to hospital.
Haloperidol also is licenced for schizophrenia and mania. Top dose haloperidol is also 30mg a day (although I can't recall prescribing an older adult even 1/4 of that dose) at a reference cost of £52.28 a month and haloperidol is, usually, a drug causing a lot more side effects.
Olanzapine, in the treatment of schizophrenia and mania, has a top dose of 20mg a day, at a base cost of £158.90 a month.
I am happy to prescribe olanzapine. It seems well tolerated. It seems to work well. Aripiprazole is a newer and more expensive drug. It's a topic of conversation. It was discussed with Consultant Psychiatrists across 4 mental health hospitals. Working age and old age pschiatrists curiously formed the same view, with nobody seeming to think that aripiprazole seemed to work as well as other drugs. Some vociferously argued it didn't work at all.
Spending a few thousand a year on a drug that works and prevents admission both improves my patient's life and saves the NHS money.
Prescribing a drug that's of dubious effectiveness, hmmm.
Has anyone had decent results from this drug? I've yet to hear of it . . .