Real-World Outcomes and Practice Patterns for Long-Acting Injectable Vs. Oral Antipsychotic Agents Among Hospitalized Patients with Schizophrenia in the United States
Author(s)
Kane JM1, Rubio JM1, Casciano J2, Dotiwala Z2, Hansen R3, Franzenburg KR4, Philbin M5, Thompson S6
1The Zucker Hillside Hospital, Northwell Health, Dept. of Psychiatry; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Dept. of Psychiatry and Molecular Medicine; Feinstein Institutes for Medical Research, Institute of Behavioral Science, Glen Oaks, NY, USA, 2eMAX Health, White Plains, NY, USA, 3Teva Branded Pharmaceutical Products R&D, Inc., North America Medical Affairs, Parsippany, NJ, USA, 4Teva Branded Pharmaceutical Products R&D, Inc., Global Medical Affairs, West Chester, PA, USA, 5Teva Branded Pharmaceutical Products R&D, Inc., Value Evidence and Outcomes, Parsippany, NJ, USA, 6Teva Branded Pharmaceutical Products R&D, Inc., Global Health Economics and Outcomes Research, West Orange, NJ, USA
Presentation Documents
OBJECTIVES: Treatment options for schizophrenia include oral antipsychotics (OAs) and long-acting injectable antipsychotics (LAIs). Previous studies have reported that patients taking LAIs have lower relapse/re-hospitalization risks; however, more patients are prescribed OAs than LAIs. Here, we explore differences in re-hospitalization rates after schizophrenia-related hospitalization for patients prescribed LAIs vs OAs at discharge.
METHODS: The study included adults in the Premier Hospital Database (a US hospital-based, service-level, all-payer database containing records collected for billing purposes at the hospital level) with a schizophrenia-related hospitalization between December 2019 and June 2021 who were prescribed LAIs or OAs at discharge. The date of the first schizophrenia-related hospitalization during the study period is the index date. Prescribing patterns and re-hospitalization risk were analyzed for ≥3 months pre- and post-index.
RESULTS: At discharge 23,336 (84%) patients were prescribed OAs vs 4293 (16%) prescribed LAIs (1,303 [30%] were prescribed atypical LAIs vs 2,990 [70%] prescribed typical LAIs). The most common OA prescribed was risperidone (26%), and the most common LAI was haloperidol (combined with haloperidol OA; 37%). Greater proportions of patients were re-hospitalized within 30, 60, and 90 days after discharge with OAs (11%, 15%, and 18%, respectively) vs LAIs (8%, P<.0001; 12%, P<.0001; 15%, P<.0001; risk reduction: 18%, 14%, and 10%), and after discharge with typical (9%, 13%, and 16%) vs atypical (7%, P=.012; 10%, P=.004; 13%, P=.004; risk reduction: 35%, 32%, and 26%) LAIs.
CONCLUSIONS: Most patients with schizophrenia-related hospitalizations were prescribed OAs at discharge; however, patients prescribed LAIs had significantly less re-hospitalizations. Of those prescribed an LAI at discharge, most were prescribed a typical LAI; however, patients prescribed an atypical LAI had the lowest risk of re-hospitalization. These results suggest that prescribing an atypical LAI at discharge may result in lower relapse/re-hospitalization rates for patients with schizophrenia.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
HSD3
Disease
Neurological Disorders