Long-Acting Risperidone (Consta) Increases Costs, Lowers Outcomes


Writing in the Journal of Clinical Psychiatry, researchers from the Health Economics Resource Center studied the effects of long-acting injectable risperidone (Consta) on 369 patients of the VA diagnosed with schizophrenia. Consta significantly increased costs, but did not reduce hospital or health care costs or improve outcomes. It did increase the number of adverse events, such as neurologic side-effects, headaches, and pain at the injection site.

Abstract → 

From an audio recording associated with the study:
“The promise of the long-acting drug was not realized. Compared to oral medications it did not improve outcomes or save costs. Patients who were randomized to the long-acting drug incurred over $4000 greater annual medication costs. The long-acting drug did not reduce days of hospitalization or other health care costs. It did not reduce psychiatric symptoms or improve overall health-related quality of life. But it did increase the number of adverse events, such as neurologic side-effects, headaches, and pain at the injection site.
“Medicaid is the most important sponsor of care for schizophrenia in the United States and spends $3 billion per year on antipsychotics; more than any other therapeutic drug class. The study concludes that excluding long-acting risperidone from formularies would help medicaid and other payers avoid a substantial new drug cost with no loss in patient welfare.”


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].