Economic Impact in Medicaid Beneficiaries with Schizophrenia and Cardiometabolic Comorbidities Treated with Once-Monthly Paliperidone Palmitate vs. Oral Atypical Antipsychotics.

Drugs Real World Outcomes 2018 Mar;5(1):81-90

Janssen Scientific Affairs LLC, Titusville, NJ, USA.

Objective: The objective of this study was to compare persistence, costs, and healthcare resource utilization in patients with schizophrenia and cardiometabolic comorbidities treated with once-monthly paliperidone palmitate or an oral atypical antipsychotic.

Methods: Medicaid data from six states (07/2009-03/2015) were used to identify adults with schizophrenia and cardiometabolic comorbidities initiated on once-monthly paliperidone palmitate or an oral atypical antipsychotic (index date) on 01/2010 or after. Persistence to index medication at 12 months (no gap ≥ 90 days) was compared between patients taking once-monthly paliperidone palmitate and an oral atypical antipsychotic using Chi-squared tests. The 12-month post-index healthcare costs and healthcare resource utilization were compared using multivariate ordinary least squares and Poisson regression, respectively.

Results: Selected patients taking once-monthly paliperidone palmitate (n = 371) were younger (mean age: 45.0 vs. 47.5 years, standardized difference = 24%) than patients taking oral atypical antipsychotics (n = 8296). Persistence at 12 months was higher in patients taking once-monthly paliperidone palmitate (40 vs. 33%, p = 0.006). Adjusted all-cause medical costs were lower in patients taking once-monthly paliperidone palmitate vs. patients taking oral atypical antipsychotics (mean monthly cost differences = US $ - 369, p = 0.004) while all-cause pharmacy costs were higher (mean monthly cost differences = US $279, p < 0.001), resulting in no significant difference in total costs (mean monthly cost differences = US $ - 90, p = 0.357). No significant difference was observed in cardiometabolic comorbidity-related pharmacy or medical costs. Compared with patients taking oral atypical antipsychotics, patients taking once-monthly paliperidone palmitate had more schizophrenia-related outpatient visits (incidence rate ratio = 1.44, p < 0.001) but fewer cardiometabolic comorbidity-related inpatient admissions (incidence rate ratio = 0.73, p < 0.001) with shorter lengths of stay (incidence rate ratio = 0.72, p = 0.020), and fewer cardiometabolic comorbidity-related long-term care admissions (incidence rate ratio = 0.56, p = 0.016).

Conclusions: Medicaid beneficiaries with schizophrenia and cardiometabolic comorbidities who were initiated on once-monthly paliperidone palmitate had similar 12-month total healthcare costs compared with oral atypical antipsychotics. Cardiometabolic comorbidity-related utilization of inpatient and long-term care services was lower in patients taking once-monthly paliperidone palmitate.

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http://dx.doi.org/10.1007/s40801-018-0130-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825393PMC
March 2018
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References

(Supplied by CrossRef)

JC Simeone et al.
BMC Psychiatry. 2015

CW Colton et al.
Prev Chronic Dis. 2006

CJ Bushe et al.
J Psychopharmacol. 2010

TJ Lambert et al.
Med J Aust. 2003

D Bressington et al.
BMC Psychiatry. 2016

CU Correll et al.
JAMA Psychiatry. 2014

M Hert De et al.
Br J Psychiatry. 2011

Z Fan et al.
J Psychiatr Res. 2013

AJ Mitchell et al.
Schizophr Bull. 2013

M Cloutier et al.
J Clin Psychiatry. 2016

LA Chwastiak et al.
Gen Hosp Psychiatry. 2009

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