The Clinical Antipsychotic Trials of Intervention and Effectiveness (CATIE) revealed that second-generation antipsychotics (excluding clozapine) are not significantly better than their first-generation counterparts and do not justify current expenditure levels.  This article discusses the potential avenues for curtailing drug costs, improving cost-effectiveness, and maintaining drug availability.  The authors conclude that the available policy options and the current political climate indicate that expenditures for second-generation anti-psychotics will likely remain high despite the lack of significant public health benefits.   

Rosenheck, R. A., Leslie, D. L., & Doshi, J. A. (2008). Second-generation antipsychotics: cost-effectiveness, policy options, and political decision making. Psychiatric Services, 59(5): 515-20. DOI: 10.1176/appi.ps.59.5.515. http://psychservices.psychiatryonline.org/cgi/content/abstract/59/5/515