Real-world adherence and economic outcomes associated with paliperidone palmitate versus oral atypical antipsychotics in schizophrenia patients with substance-related disorders using Medicaid benefits. (February 2018)

• Record Type: Journal Article
• Authors: Joshi, Kruti; Lafeuille, Marie-Hélène; Kamstra, Rhiannon; Tiggelaar, Sean; Lefebvre, Patrick; Kim, Edward; Yue, Yong; Tandon, Neeta
• Is Part Of: Journal of comparative effectiveness research. Volume 7:Number 2(2018)
• Page Start: 121
• Page End: 133
• Publication Date: 2018-02
• Subjects: antipsychotic adherence -- once-monthly paliperidone palmitate -- schizophrenia -- substance-related disorders; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer-2017-0043
• Languages: English
• ISSNs: 2042-6305

Abstract

Aim: Compare medication utilization, costs and healthcare resource use in schizophrenia patients with substance-related disorders initiated on once-monthly paliperidone palmitate (PP1M) or an oral atypical antipsychotic (OAA).Materials & methods: Data from six Medicaid states (07/2009–03/2015) were used to compare outcomes between PP1M and OAA patients.Results: PP1M patients had higher 12-month antipsychotic adherence and persistence than OAA patients. PP1M patients had lower medical (mean monthly cost difference [MMCD] = US$-191, p = 0.020), higher pharmacy (MMCD = US$250, p < 0.001) and similar total costs (MMCD = US$59, p = 0.517) during the overall follow-up. PP1M patients had lower rates of outpatient visits and inpatient days but higher rates of mental health-related utilization.Conclusion: PP1M was associated with higher antipsychotic adherence and persistence, and similar total costs versus OAA.