The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving

Edwards, Natalie C; Muser, Erik; Doshi, Dilesh; Fastenau, John

doi:10.3111/13696998.2012.667465

Cited by 11 publications

(3 citation statements)

References 42 publications

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“…A decision-analytic model of paliperidone palmitate versus atypical oral antipsychotics showed paliperidone palmitate had lower total medical costs and greater effectiveness (i.e., dominant decision) 3 .…”

Section: Introductionmentioning

confidence: 99%

Cost effectiveness of paliperidone palmitate versus oral antipsychotics in patients with schizophrenia and a history of criminal justice involvement

Muser

Kozma²,

Benson

et al. 2015

Journal of Medical Economics

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Costs for HC/CJS events avoided offset 25% of the greater drug cost for the paliperidone palmitate versus oral antipsychotic treatment group in this vulnerable population. Use of a recall-dependent RUQ for event rates and cost estimates instead of actual costs are potential limitations and may make the results conservative from a state government perspective. Indirect costs are likely to be substantial for this population, but were not considered in the analysis.

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Section: Introductionmentioning

confidence: 99%

Cost effectiveness of paliperidone palmitate versus oral antipsychotics in patients with schizophrenia and a history of criminal justice involvement

Muser

Kozma²,

Benson

et al. 2015

Journal of Medical Economics

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“…In a study population of previously incarcerated patients, the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) trial reported a significant delay in treatment failure among those randomly assigned to PP, relative to those assigned to OAT [ 23 ]. Additionally, in a study conducted from the US healthcare payer perspective, PP was shown to be more cost-effective relative to OAT; specifically, PP patients had fewer mean annual days of relapse (8.7 days vs 17.8 days) and lower mean annual costs ($20,995 vs $22,481) [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison and predictors of treatment adherence and remission among patients with schizophrenia treated with paliperidone palmitate or atypical oral antipsychotics in community behavioral health organizations

et al. 2017

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BackgroundNonadherence to antipsychotic treatment increases the likelihood of relapse and progressive symptomatology in patients with schizophrenia. Atypical long-acting injectables, including paliperidone palmitate (PP), may increase adherence and improve symptoms. This study compared and assessed predictors of treatment patterns and symptom remission among schizophrenia patients treated with PP versus atypical oral antipsychotic therapy (OAT) in community behavioral health organizations (CBHOs).MethodsThis retrospective cohort analysis evaluated 763 patients with schizophrenia and new (PP-N; N = 174) or continuing (PP-C; N = 308) users of PP, or new users of OAT (N = 281) at enrollment in the REACH-OUT study (2010–2013). Treatment outcomes assessed at 1 year were discontinuation, and adherence, measured by proportion of days covered (PDC) or medication possession ratio (MPR). Remission status was assessed using the Structured Clinical Interview for Symptoms of Remission (SCI-SR). A machine learning platform, Reverse Engineering and Forward Simulation (REFS™), was used to identify predictors of study outcomes. Multivariate Cox and generalized linear regressions estimated the adjusted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals.ResultsAmong PP-N users, 27% discontinued their initial treatment regimen versus 51% (p < 0.001) of OAT users. PP-N (vs OAT; HR = 0.49 [0.31–0.76]) users and males (HR = 0.65 [0.46–0.92]) had significantly lower rates of discontinuation. Relative to OAT, PP-N had a 36% [31%–42%] higher MPR and a 10-fold increased achievement of PDC ≥80% (OR = 10.46 [5.72–19.76]). PP users were significantly more likely to achieve remission in follow-up (PP-N vs OAT: OR = 2.65 [1.39–5.05]; PP-C vs OAT: OR = 1.83 [1.03–3.25]).ConclusionsRelative to OAT, PP was associated with improved adherence, less frequent treatment discontinuation, and improved symptom remission in this CBHO study population.

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“…Edwards et al 35 investigated the threshold at which PP1M is more cost efficient than OAAs, and reported that PP1M patients saved $1486 in healthcare costs compared to patients with schizophrenia treated with OAAs. Furthermore, Pennington and McCrone 36 reported that patients with schizophrenia can experience excess relapse costs of $6033-$32,753, attributable to hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Transitioning from oral risperidone or paliperidone to once-monthly paliperidone palmitate: a real-world analysis among Veterans Health Administration patients with schizophrenia who have had at least one prior hospitalization

Khoury

Patel

Huang

et al. 2019

Current Medical Research and Opinion

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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 allcause 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 ¼ 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

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The threshold rate of oral atypical anti-psychotic adherence at which paliperidone palmitate is cost saving

Abstract: Although uptake of LAIs in the US has not been as rapid as elsewhere, many thought leaders emphasize their importance in optimizing outcomes in patients with adherence problems. The findings of this analysis support the cost-effectiveness of paliperidone palmitate in these patients.

Cited by 11 publications

References 42 publications

Cost effectiveness of paliperidone palmitate versus oral antipsychotics in patients with schizophrenia and a history of criminal justice involvement

Cost effectiveness of paliperidone palmitate versus oral antipsychotics in patients with schizophrenia and a history of criminal justice involvement

Comparison and predictors of treatment adherence and remission among patients with schizophrenia treated with paliperidone palmitate or atypical oral antipsychotics in community behavioral health organizations

Transitioning from oral risperidone or paliperidone to once-monthly paliperidone palmitate: a real-world analysis among Veterans Health Administration patients with schizophrenia who have had at least one prior hospitalization

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