TRANSPORTING REAL-WORLD OUTCOMES OF PATIENTS FROM THE UNITED STATES TO THE UNITED KINGDOM: THE CHALLENGING USE CASE OF PATIENTS WITH SCHIZOPHRENIA
Author(s)
Florence Brellier, MSc, PhD1, Sophia Ho, MPharm2, Miriam King, BA2, Tobias Bluhmki, MSc PhD3, Christopher F. Brewer, MBioch MBBS MRCS MFPM2.
1Real-World Data Research, Bristol Myers Squibb, Uxbridge, United Kingdom, 2Bristol Myers Squibb, Uxbridge, United Kingdom, 3Bristol Myers Squibb, München, Germany.
1Real-World Data Research, Bristol Myers Squibb, Uxbridge, United Kingdom, 2Bristol Myers Squibb, Uxbridge, United Kingdom, 3Bristol Myers Squibb, München, Germany.
OBJECTIVES: In ex-US settings where data access is challenging, the concept of transportability (using statistical approaches to extend conclusions from one population to another based on patient characteristics) has attracted interest. While applications in oncology are expanding, transportability in schizophrenia was explored.
METHODS: A retrospective cohort study was conducted in patients with schizophrenia who initiated olanzapine in 2018-2024 using OMNY Health in the US (electronic health database (EHR) linked to claims) and Clinical Practice Research Datalink (CPRD) Aurum (primary care EHR) linked to secondary care in the UK. Completeness of variables required to perform inverse odds of participation weighting (IOPW) and time-to-treatment-discontinuation (permissible gap between end of record and start of subsequent record: 60 days) were assessed to evaluate US to UK transportability feasibility.
RESULTS: Inclusion criteria were met by 10,074 and 1,817 patients in OMNY and CPRD, respectively. Completeness of variables for IOPW ranged from high (age, gender, and ethnicity: 96.1-100%) to low (OMNY socio-economic status: 2.7%). Olanzapine time-to-discontinuation differed greatly with a median of 20 days [95%CI: 18-22] in OMNY and 231 days [196-259] in CPRD. Limited chronological EHR/pharmacy claims overlap was observed in OMNY: 875 patients (8.7%) had an overlap of > 1 year considered continuous. Furthermore, 6,941 (68.9%) patients had >1 olanzapine record in OMNY. This restricted longitudinality may have underestimated treatment duration. As transportability methods adjust for differences in patient characteristics but not in data collection/healthcare settings, findings were considered insufficiently comparable across CPRD and OMNY datasets to proceed to transportability.
CONCLUSIONS: The short longitudinality observed in OMNY might reflect US healthcare system fragmentation, likely accentuated in schizophrenia where patients change physicians and payers regularly. It may also relate to OMNY data capture characteristics. Given that transportability requires high completeness in baseline characteristics and sufficient follow-up, rich patient-centric data may better support its implementation in schizophrenia.
METHODS: A retrospective cohort study was conducted in patients with schizophrenia who initiated olanzapine in 2018-2024 using OMNY Health in the US (electronic health database (EHR) linked to claims) and Clinical Practice Research Datalink (CPRD) Aurum (primary care EHR) linked to secondary care in the UK. Completeness of variables required to perform inverse odds of participation weighting (IOPW) and time-to-treatment-discontinuation (permissible gap between end of record and start of subsequent record: 60 days) were assessed to evaluate US to UK transportability feasibility.
RESULTS: Inclusion criteria were met by 10,074 and 1,817 patients in OMNY and CPRD, respectively. Completeness of variables for IOPW ranged from high (age, gender, and ethnicity: 96.1-100%) to low (OMNY socio-economic status: 2.7%). Olanzapine time-to-discontinuation differed greatly with a median of 20 days [95%CI: 18-22] in OMNY and 231 days [196-259] in CPRD. Limited chronological EHR/pharmacy claims overlap was observed in OMNY: 875 patients (8.7%) had an overlap of > 1 year considered continuous. Furthermore, 6,941 (68.9%) patients had >1 olanzapine record in OMNY. This restricted longitudinality may have underestimated treatment duration. As transportability methods adjust for differences in patient characteristics but not in data collection/healthcare settings, findings were considered insufficiently comparable across CPRD and OMNY datasets to proceed to transportability.
CONCLUSIONS: The short longitudinality observed in OMNY might reflect US healthcare system fragmentation, likely accentuated in schizophrenia where patients change physicians and payers regularly. It may also relate to OMNY data capture characteristics. Given that transportability requires high completeness in baseline characteristics and sufficient follow-up, rich patient-centric data may better support its implementation in schizophrenia.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MSR79
Topic
Epidemiology & Public Health, Methodological & Statistical Research, Real World Data & Information Systems
Disease
Neurological Disorders