Economic Impact in Medicaid Beneficiaries with Schizophrenia and Cardiometabolic Comorbidities Treated with Once-Monthly Paliperidone Palmitate vs. Oral Atypical Antipsychotics

摘要

ObjectiveThe objective of this study was to compare persistence, costs, and healthcare resource utilization in patients with schizophrenia and cardiometabolic comorbidities treated with once-monthly paliperidone palmitate or an oral atypical antipsychotic. MethodsMedicaid data from six states (07/2009–03/2015) were used to identify adults with schizophrenia and cardiometabolic comorbidities initiated on once-monthly paliperidone palmitate or an oral atypical antipsychotic (index date) on 01/2010 or after. Persistence to index medication at 12?months (no gap?≥?90?days) was compared between patients taking once-monthly paliperidone palmitate and an oral atypical antipsychotic using Chi-squared tests. The 12-month post-index healthcare costs and healthcare resource utilization were compared using multivariate ordinary least squares and Poisson regression, respectively. ResultsSelected patients taking once-monthly paliperidone palmitate ( n =?371) were younger (mean age: 45.0 vs. 47.5?years, standardized difference?=?24%) than patients taking oral atypical antipsychotics ( n =?8296). Persistence at 12?months was higher in patients taking once-monthly paliperidone palmitate (40 vs. 33%, p =?0.006). Adjusted all-cause medical costs were lower in patients taking once-monthly paliperidone palmitate vs. patients taking oral atypical antipsychotics (mean monthly cost differences?=?US $???369, p =?0.004) while all-cause pharmacy costs were higher (mean monthly cost differences?=?US $279, p ConclusionsMedicaid beneficiaries with schizophrenia and cardiometabolic comorbidities who were initiated on once-monthly paliperidone palmitate had similar 12-month total healthcare costs compared with oral atypical antipsychotics. Cardiometabolic comorbidity-related utilization of inpatient and long-term care services was lower in patients taking once-monthly paliperidone palmitate.