Comments on Cost Analysis of Risperidone Versus Olanzapine

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Sir: Taylor et al.¹ report a naturalistic nonrandomized retrospective study comparing inpatient costs for risperidone with olanzapine. The disadvantages inherent to a nonrandomized study (with no blinding) are not the only shortcomings of the study, and therefore, its results should be interpreted with caution.

First, the study reflects a viewpoint from a hospital’s perspective as opposed to a societal perspective. A consequence of this narrow viewpoint of studying only inpatients is that it is not known whether patients discharged early differ from those discharged late in their utilization of outpatient resources and subsequent course of illness.