Pmh8 Clinical and Economic Impact of Relapse in Patients With Opioid Use Disorder in the Us

Abstract

Objectives: To compare all-cause and psychiatric hospitalizations among adult patients with schizophrenia newly treated with brexpiprazole versus other US FDA-approved oral atypical antipsychotics (OAAs) in a real-world setting. Methods: This retrospective cohort study analyzed data from 2 sources: (1) Truven Health MarketScan ® Commercial, Medicare Supplemental, and Multi-State Medicaid Databases and (2) De-identified Optum ® Clinformatics ® Datamart. Adult patients were identified if they had schizophrenia and initiated either brexpiprazole or another OAA during the study identification period [7/1/15-9/ 30/16 for MarketScan Commercial and Medicare Supplemental; 7/1/15-6/30/16 for MarketScan Medicaid; and 7/1/15-9/30/16 for Optum], and had at least 12 months of continuous enrollment before (baseline) and after (follow-up) the first date of treatment. Negative binomial regression models were conducted to test the association between treatment group (brexpiprazole versus another individual OAA) and number of hospitalizations (all-cause and psychiatric) during the 1-year follow-up period, adjusting for baseline patient demographics and clinical characteristics Results: The final study sample consisted of 6,254 patients with schizophrenia: 176 initiated brexpiprazole; 391 ziprasidone; 453 paliperidone; 523 lurasidone; 786 aripiprazole; 1,234 quetiapine; 1,264 olanzapine; and 1,427 risperidone. When controlling for differences in baseline characteristics, no statistically significant differences were observed between brexpiprazole users and other OAAs, although brexpiprazole users had numerically lower adjusted numbers of all-cause [mean (95% confidence interval [CI]): 0.663 (0.508 -0.866); p=0.595] and psychiatric [0.389 (0.280 -0.541); p=0.451] hospitalizations. Brexpiprazole users had lower rates of psychiatric hospitalizations [incident rate ratio (95%CI): 1.50 (1.04 -2.19); p=0.032] than paliperidone users. Conclusions: Patients with schizophrenia newly treated with brexpiprazole had fewer psychiatric hospitalizations in the year following treatment initiation than those newly treated with paliperidone; hospitalization rates were not statistically significantly different between brexpiprazole and other individual OAAs. Further research with a larger sample of brexpiprazole users is warranted.