TY - JOUR
T1 - Transitioning from oral risperidone or paliperidone to once-monthly paliperidone palmitate
T2 - a real-world analysis among Veterans Health Administration patients with schizophrenia who have had at least one prior hospitalization
AU - El Khoury, Antoine
AU - Patel, Charmi
AU - Huang, Ahong
AU - Wang, Li
AU - Bashyal, Richa
N1 - Funding Information:
The authors would like to acknowledge, with their permission, Catherine Callan and Jieni Li from STATinMED Research for writing and programming services, which were funded by Janssen Scientific Affairs, LLC.
Funding Information:
The authors would like to acknowledge, with their permission, Catherine Callan and Jieni Li from STATinMED Research for writing and programming services, which were funded by Janssen Scientific Affairs, LLC.
Publisher Copyright:
© 2019, © 2019 Janssen Scientific Affairs, LLC. Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/12/2
Y1 - 2019/12/2
N2 - Objective: To address gaps in the literature on healthcare resource utilization (HRU) and costs among patients with schizophrenia and prior hospitalization who transition from oral risperidone or paliperidone (oral ris/pali) to once-monthly paliperidone palmitate (PP1M) in a real-world setting by comparing treatment patterns, HRU, and costs 12-months pre- and post-transition to PP1M among Veterans Health Administration (VHA) patients affected by schizophrenia who have had ≥1 hospitalization. Methods: VHA patients with schizophrenia (aged ≥18 years) who initiated oral ris/pali, had ≥1 all-cause inpatient stay, and transitioned to PP1M from January 2015–March 2017 were included from the VHA database. The first transition date to PP1M was identified as the index date. Patients were required to have continuous health plan eligibility for 12 months pre- and post-PP1M. Outcomes were compared using the Wilcoxon signed-rank and McNemar’s test, as appropriate. Results: The study included 319 patients (mean [SD] age = 51.6 [4.2] years) during 12 months of baseline and follow-up. During pre-PP1M transition, 7.2% of the patients were adherent (proportion of days covered [PDC] ≥ 80%) to oral ris/pali. Post-PP1M transition, 27.6% of the patients were adherent to PP1M. Comparison of HRU outcomes from the pre- to post-PP1M transition revealed significantly lower all-cause inpatient stays (3.5 vs 1.4, p <.0001) and shorter inpatient length of stay (43.4 vs 18.3 days, p <.0001). Similar trends were seen for mental health and schizophrenia-related HRU. Cost outcome comparison indicated significantly lower all-cause inpatient costs ($64,702 vs $24,147, p <.0001), total medical costs ($87,917 vs $56,947, p <.0001), and total costs ($91,181 vs $69,106, p <.0001). A similar trend was observed for mental health and schizophrenia-related costs. Conclusions: Transitioning from oral ris/pali to PP1M may significantly improve HRU and provide potential cost savings in VHA patients with schizophrenia and ≥1 prior hospitalization.
AB - Objective: To address gaps in the literature on healthcare resource utilization (HRU) and costs among patients with schizophrenia and prior hospitalization who transition from oral risperidone or paliperidone (oral ris/pali) to once-monthly paliperidone palmitate (PP1M) in a real-world setting by comparing treatment patterns, HRU, and costs 12-months pre- and post-transition to PP1M among Veterans Health Administration (VHA) patients affected by schizophrenia who have had ≥1 hospitalization. Methods: VHA patients with schizophrenia (aged ≥18 years) who initiated oral ris/pali, had ≥1 all-cause inpatient stay, and transitioned to PP1M from January 2015–March 2017 were included from the VHA database. The first transition date to PP1M was identified as the index date. Patients were required to have continuous health plan eligibility for 12 months pre- and post-PP1M. Outcomes were compared using the Wilcoxon signed-rank and McNemar’s test, as appropriate. Results: The study included 319 patients (mean [SD] age = 51.6 [4.2] years) during 12 months of baseline and follow-up. During pre-PP1M transition, 7.2% of the patients were adherent (proportion of days covered [PDC] ≥ 80%) to oral ris/pali. Post-PP1M transition, 27.6% of the patients were adherent to PP1M. Comparison of HRU outcomes from the pre- to post-PP1M transition revealed significantly lower all-cause inpatient stays (3.5 vs 1.4, p <.0001) and shorter inpatient length of stay (43.4 vs 18.3 days, p <.0001). Similar trends were seen for mental health and schizophrenia-related HRU. Cost outcome comparison indicated significantly lower all-cause inpatient costs ($64,702 vs $24,147, p <.0001), total medical costs ($87,917 vs $56,947, p <.0001), and total costs ($91,181 vs $69,106, p <.0001). A similar trend was observed for mental health and schizophrenia-related costs. Conclusions: Transitioning from oral ris/pali to PP1M may significantly improve HRU and provide potential cost savings in VHA patients with schizophrenia and ≥1 prior hospitalization.
KW - Schizophrenia
KW - antipsychotic agents
KW - healthcare costs
KW - medication adherence
KW - paliperidone palmitate
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U2 - 10.1080/03007995.2019.1651129
DO - 10.1080/03007995.2019.1651129
M3 - Article
C2 - 31366251
AN - SCOPUS:85071333448
SN - 0300-7995
VL - 35
SP - 2159
EP - 2168
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 12
ER -