Real-World Patient Persistence and Adherence: A Comparison Of Long Acting Injectables and Oral Antipsychotics Used For The Treatment Of Schizophrenia in a Canadian Adult population
Author(s)
Samantha A. Feener, BSc, MBA1, Ryan Ng, PhD2, Martin Barbeau, MSc3, Gabrielle Houle, PhD2, Arushi Fraelic, BA2;
1Bausch Health, Canada Inc., Manager, Market Access, Laval, QC, Canada, 2IQVIA Solutions Canada Inc., Kirkland, QC, Canada, 3Bausch Health, Canada Inc., Laval, QC, Canada
1Bausch Health, Canada Inc., Manager, Market Access, Laval, QC, Canada, 2IQVIA Solutions Canada Inc., Kirkland, QC, Canada, 3Bausch Health, Canada Inc., Laval, QC, Canada
Presentation Documents
OBJECTIVES: Canadian guidelines suggest the use of oral antipsychotics, as well as long acting injectables (LAIs) for the management of schizophrenia. Lower rates of treatment persistence and adherence can lead to relapse which can significantly impact patient outcomes and trajectory, potentially resulting in slow or incomplete remission and increased challenges in regaining prior levels of functioning. This study aims to compare persistence and adherence of LAIs and oral antipsychotics within a 12-month analysis period.
METHODS: Anonymized patient-level data for publicly reimbursed drug transactions from IQVIA’s Ontario Drug Benefit (ODB) claims database was used. Individuals above 15 years of age were included based on their first claim for either LAI or oral formulations of risperidone, paliperidone and aripiprazole from January 2021 to April 2023. Patients were followed for 12 months. Persistence was measured from index to discontinuation (i.e., treatment gap greater or equal to 90 days or switch to another index product). The Kaplan-Meier method and log-rank tests were used to compare persistence. Adherence was measured using proportion of days covered (PDC) with a fixed denominator (365 days) and compared using a Kruskal-Wallis rank sum test with continuity correction.
RESULTS: From a cohort of 45,072 patients (LAI n = 3,059 oral n = 42,013), those indexing on LAIs demonstrate higher persistence at 3, 6, 9 and 12 months (75.4%, 64.3%, 56.9% and 51.6% respectively) compared to orals (65.5%, 54.0%, 46.8% and 42.0%, respectively). The difference in therapy persistence between groups was statistically significant (p<0.001). Patients indexed on LAIs have a significantly higher average PDC (62.2%) compared to those on oral formulations (54.0%, p<0.0001).
CONCLUSIONS: In the Canadian population studied, persistence and adherence on LAIs was statistically-significantly higher compared to their oral formulations. Strategies that support improved treatment persistence and adherence in schizophrenia patients could reduce relapse rates and improve overall patient trajectories.
METHODS: Anonymized patient-level data for publicly reimbursed drug transactions from IQVIA’s Ontario Drug Benefit (ODB) claims database was used. Individuals above 15 years of age were included based on their first claim for either LAI or oral formulations of risperidone, paliperidone and aripiprazole from January 2021 to April 2023. Patients were followed for 12 months. Persistence was measured from index to discontinuation (i.e., treatment gap greater or equal to 90 days or switch to another index product). The Kaplan-Meier method and log-rank tests were used to compare persistence. Adherence was measured using proportion of days covered (PDC) with a fixed denominator (365 days) and compared using a Kruskal-Wallis rank sum test with continuity correction.
RESULTS: From a cohort of 45,072 patients (LAI n = 3,059 oral n = 42,013), those indexing on LAIs demonstrate higher persistence at 3, 6, 9 and 12 months (75.4%, 64.3%, 56.9% and 51.6% respectively) compared to orals (65.5%, 54.0%, 46.8% and 42.0%, respectively). The difference in therapy persistence between groups was statistically significant (p<0.001). Patients indexed on LAIs have a significantly higher average PDC (62.2%) compared to those on oral formulations (54.0%, p<0.0001).
CONCLUSIONS: In the Canadian population studied, persistence and adherence on LAIs was statistically-significantly higher compared to their oral formulations. Strategies that support improved treatment persistence and adherence in schizophrenia patients could reduce relapse rates and improve overall patient trajectories.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD63
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas