Healthcare Cost Reductions Associated with the Use of LAI Formulations of Antipsychotic Medications Versus Oral Among Patients with Schizophrenia

Abstract

Real-world medication adherence and healthcare costs of patients with schizophrenia initiating long-acting injectable (LAI) vs. oral antipsychotics were compared. Patients with schizophrenia initiating LAI or oral antipsychotics (index event) were identified from MarketScan Commercial and Medicare claims databases and their medication possession ratios (MPR), pre- and post-index costs for inpatient/outpatient care were compared. Of 3,004 patients, 394 initiated LAI antipsychotics and 2,610 oral antipsychotics. Post-index, the mean MPR was greater for the LAI cohort (0.67 ± 0.34 vs. 0.56 ± 0.35; p < 0.001). Schizophrenia-related hospital costs for LAI users were reduced during the follow-up period in comparison to the pre-index period, but were increased for patients using oral antipsychotics (-$5,981 ± $16,554 vs. 758 ± 14,328, p < 0.001). The change in costs of outpatient care also favored LAI medications ($134 ± 8,280 vs. 658 ± 3,260, p = 0.023). Drug costs of LAI antipsychotics were higher ($4,132 ± 4,533 vs. 2,562 ± 2,714, p < 0.001). Schizophrenia patients initiating LAI antipsychotics incur less healthcare costs in comparison to patients initiating oral antipsychotics.

Risk factors for medication non-adherence among psychiatric patients with substance misuse histories

“…Because use of depot injection has only recently become common, previous medication adherence studies were not influenced by this practice; but it must be taken into account now (Lin, Wong, Offord, & Mirski, 2013). The current study found that apparent differences in adherence between patients with different diagnoses, particularly paranoid schizophrenia and major depression, could be accounted for by differential prescription of depot (long-acting) formulations of medication.…”

Onset and persistence of efficacy by symptom domain with long-acting injectable paliperidone palmitate in patients with schizophrenia

“…Growing evidence indicates that effective doctor--patient communication is a crucial factor in patient acceptance of treatment [54][55][56][57][58], and that physician ambivalence may negatively influence patient acceptance [59]. In addition, the higher cost of LAI antipsychotic medications may sometimes preclude their use, even though cost-effectiveness studies have reported lower hospital and outpatient care costs for patients receiving LAIs compared with oral formulations [60,61]. The use of LAI antipsychotic medications is also limited in part by uncertainty regarding onset and persistence of clinical response and management of dosing.…”

Recovery outcomes of schizophrenia patients treated with paliperidone palmitate in a community setting: patient and provider perspectives on recovery

“…LAI antipsychotics have been shown to reduce the risk of relapse, symptom-related outcomes, healthcare resource utilization (i.e., hospitalization rates), and inpatient and outpatient healthcare costs [21][22][23][24][25] . In addition to these benefits, a recent study indicated that LAI antipsychotics may 26 .…”