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The purpose of the North Carolina Clozapine Network (NCCN) is to increase clozapine use across North Carolina. Clozapine treatment for schizophrenia has consistently demonstrated superior outcomes in several measures, including improvement in quality of life and functioning and decrease symptoms, number of psychiatric hospitalizations, and mortality.* Despite these clear advantages, clozapine remains vastly underutilized nation- and state-wide. According to North Carolina Medicaid data, only 1 in ~6 individuals with treatment-resistant schizophrenia in North Carolina are prescribed this evidence-based treatment.**

Clozapine underutilization is most often due to real or perceived complexities of its use. There are various barriers to clozapine use that occur at multiple levels of care. This includes obstacles encountered by psychiatric care providers, patients, pharmacies and pharmacists, clinics, healthcare systems, and managed care organizations. Negotiating REMS, restrictions on dispensing, and lack of clozapine availability are obstacles faced by many pharmacies and pharmacists. Patients often face challenges with dose titrations and tapers, finding laboratories for the required monitoring, and locating providers who prescribe clozapine. Clinics and healthcare systems frequently face difficulty with reimbursement or generation of adequate revenue to cover the costs associated with establishing and/or operating a clozapine-capable clinic. The NCCN was founded by the UNC Center for Excellence in Community Mental Health to help address these and other barriers to clozapine use.

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NCCN Consultation Service

NCCN Facility-Based Clozapine Initiation Program

Project ECHO®: North Carolina Clozapine Network

Clozapine Toolkit

Clozapine Pharmacy Locator

Our Experts

Frequently Asked Questions (Coming Soon)
– clozapine prescribing, monitoring, side effects, and pharmacy-related inquiries

*(McEvoy et al., Am J Psychiatry, 2006; Leucht et al., Lancet, 2011; Tiihonen, Am J Psychiatry, 2011; Tiihonen, JAMA Psychiatry, 2017)

**(SAMSHA, NC Uniform Reporting System Mental Health Data, 2017; NCCN, NC Medicaid Data, 2019)