Negative Symptoms in Schizophrenia: An Observational Study of Patient Characteristics Cost and Healthcare Resource Utilization From a US Healthcare Database
Author(s)
Jing Zhao, PhD1, Ling Zhang, M.PH, M.S., M.D2, William Brady DeHart, PhD3, Claudia Hastedt, PhD4.
1Real World Data & Analytics, Global Medical Affairs, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 2Real World Data & Analytics, Global Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Value and Evidence Solutions, HEOR, Optum, Syracuse, UT, USA, 4TA CNS Retinopathy Emerging Areas, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
1Real World Data & Analytics, Global Medical Affairs, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 2Real World Data & Analytics, Global Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA, 3Value and Evidence Solutions, HEOR, Optum, Syracuse, UT, USA, 4TA CNS Retinopathy Emerging Areas, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
OBJECTIVES: Describe patient characteristics, cost, and healthcare resource utilisation (HCRU) in people with schizophrenia with and without negative symptoms (NS) (e.g. lack of motivation, social withdrawal, reduced emotional expression). Despite antipsychotic treatment, many patients with schizophrenia are experiencing NS, which places a high burden on the patient and the health care system.
METHODS: This non-interventional study used deidentified electronic health records (EHR) and claims data from the Optum Market Clarity Integrated Clinical + Claims Database to identify adults with ≥1 diagnosis of schizophrenia (ICD-10 code F20.*). Index event was a randomly selected claim with schizophrenia diagnosis between 1-Jan-2019 and 30-Sep-2022. Patients were required to have claims-based continuous enrolment in their healthcare plan for 6 months before (baseline) and 12 months after (follow-up) index date; have EHR data during baseline and follow-up; and were supplied by antipsychotics ≥90 days during baseline and at index date. NS ±6 months around index was identified using natural language processed EHR data and diagnosis codes. Baseline characteristics, treatment at index, and HCRU during follow-up are reported descriptively.
RESULTS: Of 17,104 patients with schizophrenia, 7,300 (42.7%) were identified with NS (NS-Y) and 9,804 (57.3%) without (NS-N). In the NS-Y and NS-N groups, health insurance included commercial (38.3%; 35.1%), Medicaid (32.3%; 29.9%) and Medicare (22.3%; 21.9%), respectively. Total costs of care were higher in NS-Y vs. NS-N patients $81,356 ($133,321) and $53,322 ($78,902), respectively. Schizophrenia-related costs of care were $31,598 ($65,916) and $22,227 ($50,643), respectively. The differences were mainly driven by medical costs. Schizophrenia-related cost for inpatient and emergency visits were significantly higher in NS-Y vs. NS-N. Risk of discontinuing antipsychotics during follow-up was higher in patients with NS vs. without (NS-Y, 27.6%; NS-N, 21.6%).
CONCLUSIONS: NS are associated with higher HCRU and cost. More effective treatment strategy and interventions for patients with NS is underscored.
METHODS: This non-interventional study used deidentified electronic health records (EHR) and claims data from the Optum Market Clarity Integrated Clinical + Claims Database to identify adults with ≥1 diagnosis of schizophrenia (ICD-10 code F20.*). Index event was a randomly selected claim with schizophrenia diagnosis between 1-Jan-2019 and 30-Sep-2022. Patients were required to have claims-based continuous enrolment in their healthcare plan for 6 months before (baseline) and 12 months after (follow-up) index date; have EHR data during baseline and follow-up; and were supplied by antipsychotics ≥90 days during baseline and at index date. NS ±6 months around index was identified using natural language processed EHR data and diagnosis codes. Baseline characteristics, treatment at index, and HCRU during follow-up are reported descriptively.
RESULTS: Of 17,104 patients with schizophrenia, 7,300 (42.7%) were identified with NS (NS-Y) and 9,804 (57.3%) without (NS-N). In the NS-Y and NS-N groups, health insurance included commercial (38.3%; 35.1%), Medicaid (32.3%; 29.9%) and Medicare (22.3%; 21.9%), respectively. Total costs of care were higher in NS-Y vs. NS-N patients $81,356 ($133,321) and $53,322 ($78,902), respectively. Schizophrenia-related costs of care were $31,598 ($65,916) and $22,227 ($50,643), respectively. The differences were mainly driven by medical costs. Schizophrenia-related cost for inpatient and emergency visits were significantly higher in NS-Y vs. NS-N. Risk of discontinuing antipsychotics during follow-up was higher in patients with NS vs. without (NS-Y, 27.6%; NS-N, 21.6%).
CONCLUSIONS: NS are associated with higher HCRU and cost. More effective treatment strategy and interventions for patients with NS is underscored.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH169
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas