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Psych Congress  

Evaluation of Hospitalization Resource Usage among Medicaid Insured Patients with Schizophrenia with Different Treatment Duration of Long-Acting Injectable Antipsychotic Therapy

Rimal Bera, MD
Steve Offord, PhD
Donna Zubek, BSN, MBA
Gina Lau, PharmD
Jay Lin, PhD, MBA
Craig Karson, MD
Otsuka America Pharmaceutical, Inc.

Objective: This study evaluated the impact of using long-acting injectable (LAI)/depot antipsychotics for a longer treatment duration vs. a short duration on healthcare resource usage among patients with schizophrenia who are insured by Medicaid. Methods: Schizophrenia patients ≥ 13 years of age initiating LAI antipsychotics were identified from the Thomson Reuters MarketScan® Research Medicaid database between 7/1/2005 and 6/30/2010. The study population was grouped into two study cohorts (Longer Usage Duration cohort: ≥180 days of supply and Short Usage Duration cohort: <180 days of supply). Patients were required to have 6 months of continuous medical and prescription drug insurance coverage prior to LAI initiation. Hospitalization related resource usage and costs were determined during a variable follow-up period and compared. Results: Of the 5,695 patients identified, 2,838 patients initiated LAI antipsychotics for a mean duration of 604±432 days (mean age=38.91) and 2,856 initiated treatment with them for 86±43 days (mean age=39.96). In comparison to the Short Usage Duration cohort, total hospital lengths of stay, all cause (6.56±18.63 vs. 4.93±13.40 days, p=0.0001) and schizophrenia-related (5.18±14.96 vs. 4.16±11.94 days, p=0.005), and the mean number of hospitalizations, all cause (0.79±1.78 vs. 0.61±1.41, p<0.0001) and schizophrenia-related (0.63±1.55 vs. 0.51±1.26, p=0.001) were lower for the Longer Usage Duration cohort, however total hospital payments did not significantly differ. Conclusion: Patients with schizophrenia who use LAI antipsychotic medications for less than 6 months may utilize more inpatient hospital resources than patients who have received them for longer periods.

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