Treatment Patterns and Healthcare Resource Utilization of Patients Early in Schizophrenia Illness Initiating Aripiprazole Lauroxil Versus Oral Aripiprazole: A Retrospective Claims-Based Study
Author(s)
John M. Kane, MD1, Regina Grebla, PhD2, Michael J. Doane, MA, PhD2, Andrea B. Barthel, MS3, Chenxue Liang, MS, MPH3, Zhengfan Wang, PhD3, Elizabeth S. Nagelhout, PhD3, Lauren N. Strand, PhD, MS2.
1The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell,, Hempstead, NY, USA, 2Alkermes, Inc., Waltham, MA, USA, 3Genesis Research Group, Hoboken, NJ, USA.
1The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell,, Hempstead, NY, USA, 2Alkermes, Inc., Waltham, MA, USA, 3Genesis Research Group, Hoboken, NJ, USA.
OBJECTIVES: Optimal treatment of patients with schizophrenia who are early in illness has the potential to provide long-term benefits. Long-acting injectable (LAI) antipsychotics may improve outcomes in this population. This study compared real-world treatment patterns and healthcare resource utilization (HCRU) among early-in-illness patients with schizophrenia initiating the LAI aripiprazole lauroxil (AL) versus oral aripiprazole (OA).
METHODS: This retrospective analysis used MarketScan US administrative claims data (January 1, 2016-June 30, 2022). Adults aged 18-40 years with a first observed diagnosis of schizophrenia on or after January 1, 2017, no antipsychotic claims within 12 months before diagnosis, ≥2 AL or OA claims (the first within 1 year of first schizophrenia diagnosis code), and continuous plan enrollment ≥12 months before and after their first (index) AL or OA claim were eligible. Adherence (proportion of days covered), persistence, and HCRU (proportion with ≥1 visit; visits per patient per month [PPPM]) were compared between 1:1 propensity score-matched cohorts.
RESULTS: Early-in-illness patients initiating AL (n=131) had a mean age of 27.2 years; 38.9% were female (OA: n=1222, 27.2 years, 47.1% female). In matched early-in-illness cohorts, greater adherence and longer persistence were observed for AL versus OA (both P<0.0001). Odds of ≥1 all-cause emergency department (ED) visit were significantly reduced for AL versus OA (odds ratio [95% CI], 0.59 [0.36, 0.96]). All-cause inpatient and ED visits PPPM were significantly reduced with AL versus OA (rate ratios [95% CI], 0.63 [0.45, 0.83] and 0.60 [0.43, 0.78], respectively), as were mental health-related inpatient visits PPPM (0.63 [0.45, 0.84]) and ED visits PPPM (0.50 [0.35, 0.69]).
CONCLUSIONS: Early-in-illness patients with schizophrenia initiating AL versus OA in real-world treatment settings were more persistent and adherent to treatment and had significantly lower acute HCRU. Initiating AL versus OA early in schizophrenia treatment may reduce the likelihood of acute care events.
Funding: Alkermes, Inc.
METHODS: This retrospective analysis used MarketScan US administrative claims data (January 1, 2016-June 30, 2022). Adults aged 18-40 years with a first observed diagnosis of schizophrenia on or after January 1, 2017, no antipsychotic claims within 12 months before diagnosis, ≥2 AL or OA claims (the first within 1 year of first schizophrenia diagnosis code), and continuous plan enrollment ≥12 months before and after their first (index) AL or OA claim were eligible. Adherence (proportion of days covered), persistence, and HCRU (proportion with ≥1 visit; visits per patient per month [PPPM]) were compared between 1:1 propensity score-matched cohorts.
RESULTS: Early-in-illness patients initiating AL (n=131) had a mean age of 27.2 years; 38.9% were female (OA: n=1222, 27.2 years, 47.1% female). In matched early-in-illness cohorts, greater adherence and longer persistence were observed for AL versus OA (both P<0.0001). Odds of ≥1 all-cause emergency department (ED) visit were significantly reduced for AL versus OA (odds ratio [95% CI], 0.59 [0.36, 0.96]). All-cause inpatient and ED visits PPPM were significantly reduced with AL versus OA (rate ratios [95% CI], 0.63 [0.45, 0.83] and 0.60 [0.43, 0.78], respectively), as were mental health-related inpatient visits PPPM (0.63 [0.45, 0.84]) and ED visits PPPM (0.50 [0.35, 0.69]).
CONCLUSIONS: Early-in-illness patients with schizophrenia initiating AL versus OA in real-world treatment settings were more persistent and adherent to treatment and had significantly lower acute HCRU. Initiating AL versus OA early in schizophrenia treatment may reduce the likelihood of acute care events.
Funding: Alkermes, Inc.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE376
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Mental Health (including addition)