Economic issues in access to medications: Schizophrenia treatment in England

Mental health problems and the services to address them are currently receiving more attention in the UK than ever. Mental health care in England — indeed, across the UK — is experiencing a much needed transformation. It is therefore highly pertinent to examine the patterns of psychotropic medication use, given their intended links to recovery, rehabilitation, and reintegration, as well as to explore the economic and other factors that appear to influence those patterns. These are the aims of this paper. Our attention will be primarily focused on England. What this analysis shows is that given a higher profile by government, including additional funding (although not really benefiting differentially compared to other parts of the health service) and the first national service framework, it is possible to see changes in service patterns, access and (to a degree) outcomes. These changes are occurring at a time when new classes of psychotropic medication are being introduced in a range of therapeutic areas, contributing to the relatively rapid growth of take-up but also raising questions about appropriateness, effectiveness, cost-effectiveness and equity.