Treatment Patterns, Healthcare Resource Utilization and Costs in Schizophrenia Patients Treated With Long-Acting Injectable vs Oral Antipsychotics: A Real-World Study
This poster was presented at the 30th annual Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.
Introduction: Information on treatment patterns and healthcare resource utilization among patients prescribed long-acting injectable (LAIs) versus oral antipsychotics in usual care is limited. Our goal was to evaluate these outcomes using real-world data.
Methods: The MarketScan Multi-State Medicaid database was used to identify schizophrenia patients (≥18 years) who were prescribed an LAI or oral antipsychotic between 01/01/2011-12/31/14. Propensity score matching (PSM) was used to control for differences in baseline demographic and clinical characteristics between LAI and oral cohorts. Outcomes were assessed 12 months after the index date and compared between the cohorts using chi-square/t-tests (categorical/continuous variables) and Wilcoxon rank-sum tests (utilization/costs).
Results: After PSM, 2,302 patients were included in each cohort. There was no difference in proportion of days covered, however patients prescribed orals were more likely to discontinue medication than those prescribed LAIs (45.3% vs. 30.8%). The LAI cohort had fewer inpatient admissions (0.5 vs. 0.9), hospital days (3.9 vs. 6.5) and ER visits (2.4 vs. 2.9), but also had more prescription fills (29.5 vs. 25.3) than the oral cohort. Overall costs for LAI and oral cohorts were similar with the LAIs showing higher medication costs ($505/month), and the oral cohort having greater ER ($17/m) and hospital ($397/m) costs.
Conclusions: These data suggest that patients prescribed LAIs were less likely to discontinue medication than patients prescribed oral antipsychotics, which may account for reduced inpatient admissions. Hospitalization cost reductions offset the higher costs of LAI medications.