REAL-WORLD COMPARISON OF OLANZAPINE/SAMIDORPHAN VS OLANZAPINE: AN ASSESSMENT OF TREATMENT PATTERNS AND ACUTE CARE EVENTS AMONG PATIENTS WITH SCHIZOPHRENIA OR BIPOLAR I DISORDER
Author(s)
Hemangi Panchmatia, MSc1, Rakesh Jain, MD2, Alejandro G. Hughes, MPH3, Michael J. Doane, MA, PhD1, Craig Chepke, MD4, Andrew J. Cutler, MD5.
1Alkermes, Inc., Waltham, MA, USA, 2Department of Psychiatry, Texas Tech University School of Medicine-Permian Basin, Midland, TX, USA, 3Optum, Inc., Eden Prairie, MN, USA, 4Excel Psychiatric Associates, P.A, Huntersville, NC, USA, 5Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
1Alkermes, Inc., Waltham, MA, USA, 2Department of Psychiatry, Texas Tech University School of Medicine-Permian Basin, Midland, TX, USA, 3Optum, Inc., Eden Prairie, MN, USA, 4Excel Psychiatric Associates, P.A, Huntersville, NC, USA, 5Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
OBJECTIVES: Combined olanzapine and samidorphan (OLZ/SAM) provides the antipsychotic efficacy of olanzapine while mitigating olanzapine-associated weight gain. In a 4-year open-label study, OLZ/SAM maintained symptom control, with small changes in body weight and minimal changes in lipid/glycemic parameters. This study compared treatment patterns and acute care events in patients with schizophrenia or bipolar I disorder (BD-I) initiating OLZ/SAM versus olanzapine.
METHODS: This claims analysis used Komodo Healthcare Map data (10/18/2020-12/31/2023). Medicaid-insured adults with schizophrenia or BD-I with ≥1 OLZ/SAM or olanzapine claim were eligible; OLZ/SAM claims were prioritized over olanzapine claims to set the index date. Patients were propensity score matched 1:1 on baseline demographic/clinical variables between the OLZ/SAM and olanzapine cohorts. Treatment patterns (adherence, persistence, discontinuation), acute care events including inpatient (IP) admissions and emergency department (ED) visits (all cause, mental health related, or disease related [often used as a proxy for relapse]), and numbers of days hospitalized/patient were compared during the 12-month follow-up period.
RESULTS: After matching, 1614 patients with schizophrenia (OLZ/SAM, n=807; olanzapine, n=807) and 1008 with BD-I (OLZ/SAM, n=504; olanzapine, n=504) were included. In both cohorts, OLZ/SAM was associated with significantly higher adherence, longer persistence, and lower discontinuation rates versus olanzapine. OLZ/SAM was associated with significantly lower likelihood of ≥1 all-cause, mental health-related, or disease-related IP admission (odds ratio [OR] range, schizophrenia: 0.52-0.59; BD-I: 0.52-0.58) or ED visit (OR range, schizophrenia: 0.47-0.54; BD-I: 0.62-0.74). Across all-cause, mental health-related, and disease-related events, mean numbers of days hospitalized/patient were significantly lower (range, schizophrenia: -4.7 to -5.7 days; BD-I: -3.2 to -4.5 days) for OLZ/SAM versus olanzapine.
CONCLUSIONS: OLZ/SAM treatment offers meaningful real-world effectiveness benefits over olanzapine, as observed by favorable treatment patterns and significantly lower likelihood of acute care events. Significantly lower likelihood of disease-related acute care events suggests a lower likelihood of relapse with OLZ/SAM treatment vs olanzapine.
METHODS: This claims analysis used Komodo Healthcare Map data (10/18/2020-12/31/2023). Medicaid-insured adults with schizophrenia or BD-I with ≥1 OLZ/SAM or olanzapine claim were eligible; OLZ/SAM claims were prioritized over olanzapine claims to set the index date. Patients were propensity score matched 1:1 on baseline demographic/clinical variables between the OLZ/SAM and olanzapine cohorts. Treatment patterns (adherence, persistence, discontinuation), acute care events including inpatient (IP) admissions and emergency department (ED) visits (all cause, mental health related, or disease related [often used as a proxy for relapse]), and numbers of days hospitalized/patient were compared during the 12-month follow-up period.
RESULTS: After matching, 1614 patients with schizophrenia (OLZ/SAM, n=807; olanzapine, n=807) and 1008 with BD-I (OLZ/SAM, n=504; olanzapine, n=504) were included. In both cohorts, OLZ/SAM was associated with significantly higher adherence, longer persistence, and lower discontinuation rates versus olanzapine. OLZ/SAM was associated with significantly lower likelihood of ≥1 all-cause, mental health-related, or disease-related IP admission (odds ratio [OR] range, schizophrenia: 0.52-0.59; BD-I: 0.52-0.58) or ED visit (OR range, schizophrenia: 0.47-0.54; BD-I: 0.62-0.74). Across all-cause, mental health-related, and disease-related events, mean numbers of days hospitalized/patient were significantly lower (range, schizophrenia: -4.7 to -5.7 days; BD-I: -3.2 to -4.5 days) for OLZ/SAM versus olanzapine.
CONCLUSIONS: OLZ/SAM treatment offers meaningful real-world effectiveness benefits over olanzapine, as observed by favorable treatment patterns and significantly lower likelihood of acute care events. Significantly lower likelihood of disease-related acute care events suggests a lower likelihood of relapse with OLZ/SAM treatment vs olanzapine.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO138
Topic
Clinical Outcomes