Real-World Adherence, Healthcare Resource Utilization, And Costs Among Patients With Schizophrenia Utilizing Once-Monthly, Once-Every-Three-Months, And Once-Every-Six-Months Paliperidone Palmitate in the United States
Author(s)
Charmi Patel, MPH1, Dominic Pilon, MA2, Laura Morrison, MPH2, Arthur Voegel, MA3, Lilian Diaz, MScPH2, Kana Yokoji, MScPH2, Carmela Benson, MS, MSc1;
1Janssen Scientific Affairs, LLC, a Johnson & Johnson company, Titusville, NJ, USA, 2Analysis Group, Inc., Montreal, QC, Canada, 3Analysis Group, Inc., New York, NY, USA
1Janssen Scientific Affairs, LLC, a Johnson & Johnson company, Titusville, NJ, USA, 2Analysis Group, Inc., Montreal, QC, Canada, 3Analysis Group, Inc., New York, NY, USA
Presentation Documents
OBJECTIVES: Once-every-6-months paliperidone palmitate (PP6M) is the longest dosing interval long-acting injectable (LAI) antipsychotic, followed by once-every-three-months paliperidone palmitate (PP3M). Patients are eligible for PP6M after 1 dose of PP3M or adequate treatment with once-monthly paliperidone palmitate (PP1M) per label. This study described outcomes among patients using PP6M, PP3M, and PP1M.
METHODS: Closed claims Komodo Research Data (01/01/2016-12/31/2023) were used to select three cohorts of adults with schizophrenia with ≥12 months of pre-index insurance or Medicaid/Medicare eligibility and no bipolar/pregnancy diagnoses. Patients had ≥4 PP1M, ≥1 PP3M, or ≥1 PP6M claim(s) (index date: first PP1M/PP3M/PP6M claim on/after 09/01/2021). Demographics were evaluated at index. Adherence to the index agent (proportion of days covered ≥80%), schizophrenia-related inpatient admissions, and all-cause costs (2023 US dollars; per-patient-per-year [PPPY]) were reported from index to earliest of end of eligibility or data.
RESULTS: Mean age across cohorts was 40.6-41.3 years and 24.8%-28.2% were female, based on 17,463 (PP1M), 5,348 (PP3M), and 628 (PP6M) patients with mean follow-up of 16.0 months (PP1M), 14.2 months (PP3M), and 9.4 months (PP6M). Among patients with 12 months of post-index data, 51.4% (PP1M), 59.1% (PP3M), and 73.9% (PP6M) were adherent at 12 months. The proportion of patients with a schizophrenia-related inpatient admission within 3 months post-index, among those with available data, was 5.1% (PP1M), 2.1% (PP3M), and 1.8% (PP6M). Mean total all-cause costs and medical costs PPPY were $49,221 and $22,116 (PP1M), $45,143 and $16,030 (PP3M), and $53,247 and $14,217 (PP6M). PP6M demonstrated the lowest medical to total all-cause cost ratio of 26.7% (PP3M: 35.5%; PP1M: 44.9%).
CONCLUSIONS: In this real-world descriptive study, patients with schizophrenia using PP3M or PP6M were more adherent, incurred lower medical costs, and a lower proportion had a schizophrenia-related inpatient admission relative to patients using PP1M, suggesting LAIs with longer dosing intervals may improve clinical outcomes and decrease medical costs.
METHODS: Closed claims Komodo Research Data (01/01/2016-12/31/2023) were used to select three cohorts of adults with schizophrenia with ≥12 months of pre-index insurance or Medicaid/Medicare eligibility and no bipolar/pregnancy diagnoses. Patients had ≥4 PP1M, ≥1 PP3M, or ≥1 PP6M claim(s) (index date: first PP1M/PP3M/PP6M claim on/after 09/01/2021). Demographics were evaluated at index. Adherence to the index agent (proportion of days covered ≥80%), schizophrenia-related inpatient admissions, and all-cause costs (2023 US dollars; per-patient-per-year [PPPY]) were reported from index to earliest of end of eligibility or data.
RESULTS: Mean age across cohorts was 40.6-41.3 years and 24.8%-28.2% were female, based on 17,463 (PP1M), 5,348 (PP3M), and 628 (PP6M) patients with mean follow-up of 16.0 months (PP1M), 14.2 months (PP3M), and 9.4 months (PP6M). Among patients with 12 months of post-index data, 51.4% (PP1M), 59.1% (PP3M), and 73.9% (PP6M) were adherent at 12 months. The proportion of patients with a schizophrenia-related inpatient admission within 3 months post-index, among those with available data, was 5.1% (PP1M), 2.1% (PP3M), and 1.8% (PP6M). Mean total all-cause costs and medical costs PPPY were $49,221 and $22,116 (PP1M), $45,143 and $16,030 (PP3M), and $53,247 and $14,217 (PP6M). PP6M demonstrated the lowest medical to total all-cause cost ratio of 26.7% (PP3M: 35.5%; PP1M: 44.9%).
CONCLUSIONS: In this real-world descriptive study, patients with schizophrenia using PP3M or PP6M were more adherent, incurred lower medical costs, and a lower proportion had a schizophrenia-related inpatient admission relative to patients using PP1M, suggesting LAIs with longer dosing intervals may improve clinical outcomes and decrease medical costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE375
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Mental Health (including addition)