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Psych Congress  

Impact on Healthcare Resource Usage and Costs among Medicaid Insured Schizophrenia Patients who Initiated Long-Acting Injectable Antipsychotics

Rimal Bera, MD
Steve Offord, PhD
Donna Zubek, BSN, MBA
Gina Lau, PharmD
Jay Lin, PhD, MBA
Craig Karson, MD
Otsuka America Pharmaceutical, Inc.

Objective: This study assessed the healthcare resource usage and costs before and after initiating LAI antipsychotics among Medicaid insured schizophrenia patients. Methods: Schizophrenia patients ≥13 years of age initiating LAI antipsychotics were identified from the Thomson Reuters MarketScan® Research Medicaid database between 7/1/2005 and 6/30/2010. Patients were required to have 6 months of continuous medical/prescription drug coverage prior to (baseline) LAI initiation and during a variable follow-up period. Annualized healthcare resource usage and costs for the baseline and follow-up periods were determined and compared. Results: Among 5,694 eligible patients, 55% were male and 45% were female with the majority of the population between the ages of 18 and 55 (86%). The study population had low comorbidity as assessed by Charlson Comorbidity Index (CCI), with 67% having a CCI of 0. Diabetes (17%) and chronic pulmonary disease (14%) were the most prevalent comorbidities. In comparison to the baseline period, during the follow-up period (mean duration=25.7 months) the mean number of hospitalizations, all cause (1.52±2.41 vs. 0.70±1.61, p<0.0001) and schizophrenia-related (1.21±2.04 vs. 0.57±1.41, p=0.001) declined as well as hospital lengths of stay (all cause: 14.77±28.61 vs. 5.75±16.26 days, p<0.0001; schizophrenia-related: 12.39±25.86 vs. 4.67±13.54 days, p<0.0001). As a result, annualized hospital payments were much lower (all cause: $16,249±$35,404 vs. $7,380±$21,087, p<0.0001; schizophrenia-related: $13,388±$31,614 vs. $5,645±$15,767, p<0.0001). Conclusion: For patients with schizophrenia who initiate LAI antipsychotic therapy, there is an improvement in disease management based on fewer hospitalizations for relapses, which is also associated with a marked reduction in total healthcare costs.

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