Clozapine is a new type of neuroleptic that may have a profound impact on the service utilization and outcomes of treatment-resistent, severely and persistently disable schizophrenic patients. However, Clozapine treatment is expensive. The true financial impact of alternate public mental health system policies regarding the allocation of Clozapine treatment should be known. Lack of this information may result in both failure to serve this disabled group effectively and a waste of public treatment resources. This information should be obtained as soon as possible and in a form that is most applicable to public mental health system decisions regarding resource allocation. Therefore, a new model of interstate and public-academic research collaboration is proposed that: 1) Draws upon experienced public mental health system and university investigators for a national planning effort, 2) Offers a design """"""""kit"""""""" to speed the planning of trials, 3) Offers accessible, subsidized consultation to state mental health authorities on trial planning and execution, 4) Offers a national data analysis support, and 5) Pools multi-state data to broaden the relevance of results. The approach also offers a promising model for public-academic collaboration on other pressing services resource allocation policy questions. The proposed project will engage state and university investigators in planning activities to develop a Clozapine cost-effectiveness trial """"""""kit"""""""", and support consultation and coordination costs for implementing a cooperative Clozapine trial at multiple public sites.
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