OBJECTIVES:

Schizophrenia is a burdensome disease requiring consistent long-term treatment. Antipsychotic medication switching is common and nonadherence to oral antipsychotics is reported in up to two-thirds of patients with schizophrenia. Lumateperone is a mechanistically novel antipsychotic that was initially FDA-approved in December 2019 to treat adults with schizophrenia. In December 2021, lumateperone was approved to treat depressive episodes associated with bipolar I or bipolar II disorder, as monotherapy and as adjunctive therapy with lithium or valproate. This analysis evaluated real-world persistency of lumateperone 42 mg to treat schizophrenia using open claims databases.

METHODS:

The Symphony database was used to investigate persistency of lumateperone to treat schizophrenia from March 2020-January 2022. Persistency was investigated over time and in subgroups based on geography, prescribing provider type, and payer type. The persistency of lumateperone for the first year after launch (June 2021 cutoff) was compared with launch-adjusted data from Symphony for the first-year persistency of cariprazine.

RESULTS:

The persistency of lumateperone for schizophrenia treatment (January 2022 cutoff) decreased over time, with a 3-month persistency of 48.3% which decreased gradually to 17.1% at 1-year. Similar persistency rates occurred when prescribed by a psychiatrist (50.9%), nurse practitioner (51.5%), or primary care practitioner (48.7%). Persistency by US state ranged from 23.1% (South Dakota) to 66.7% (Vermont). Persistency rates over time were similar between patients initially prescribed lumateperone in the 2^nd quarter of 2020 to the 1^st quarter of 2021. By payer, 3-month persistency was highest in those paying via Medicare (51.8%) or Managed Medicaid (51.0%). Compared with the initial launch of cariprazine in schizophrenia, lumateperone (June 2021 data cutoff) had better persistency over 12-months (lumateperone vs cariprazine persistency; 3-month, 50.1% vs 42.8%; 12-month, 9.1% vs 5.9%).

CONCLUSIONS:

Real-world persistency of lumateperone to treat schizophrenia was as expected based on historical experience of approved second generation antipsychotics.