Background: Aripiprazole and other atypical antipsychotics are important treatment options for BPD patients. Objective: To summarize real-world data of medical costs and utilization in patients with BPD treated with aripiprazole, olanzapine, quetiapine, risperidone, or ziprasidone. Methods: Three retrospective cohort studies of BPD patients initiated with atypical antipsychotics were conducted using commercial (Studies 1 and 2) or Medicaid (Study 3) claims databases. Patients were required to have 6 months continuous eligibility before their first claim for an atypical antipsychotic (pre-index period) and outcomes were assessed for 3 months (Studies 1 and 2) or 12 months (Study 3) in the post-index period. Study 1 used time-on-treatment to examine outcomes, Study 2 used time-on-treatment (costs) or intent-to-treat (hospitalization), and Study 3 used intent-to-treat methodology. Adjusted medical costs and hospitalization rates were compared using propensity-score matching (Study 1) or multivariate regression models (Studies 2 and 3) to control for baseline demographic and clinical characteristics. Results: Total adjusted medical costs per treated patient per month in Study 1 were significantly (p<0.05) lower for aripiprazole compared with olanzapine ($1569.60 versus $1874.90), quetiapine ($1462.80 versus $1780.70), risperidone ($1466.90 versus $1835.60), and ziprasidone ($1605.40 versus $2027.10). Total hospitalization rates were: aripiprazole versus olanzapine (7.7% versus 10.6%), quetiapine (7.5% versus 9.5%), risperidone (7.4% versus 10.9%; p<0.05), and ziprasidone (8.4% versus 11.6%). Results from Studies 2 and 3 were consistent with results from Study 1. Conclusions: Results from these studies indicate that in patients with BPD, aripiprazole may be associated with lower medical costs and hospitalization rates compared to other atypical antipsychotics.
Iftekhar Kalsekar, PhD; Anagha Nadkarni, PhD; Kimberly Laubmeier, PhD; Tony Hebden, PhD
Bristol-Myers Squibb and Otsuka Pharmaceutical Co., Ltd.