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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

Authors  
Rimal Bera, MD
Steve Offord, PhD
Donna Zubek, BSN, MBA
Gina Lau, PharmD
Jay Lin, PhD, MBA
Craig Karson, MD
Sponsor  
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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