OBJECTIVES: Compare antipsychotic adherence and costs among patients with schizophrenia identified as “high-risk” for future antipsychotic nonadherence by the Assessment for Quality Improvement and Risk Evaluation (QI-RE) tool to controls not identified as high-risk.  QI-RE is a software tool developed by Janssen Scientific Affairs, LLC and Boston Health Economics, Inc. that applies adapted published regression equations to pharmacy and medical claims data to assess schizophrenic patients’ risk for future antipsychotic nonadherence. METHODS: Retrospective analysis using pharmacy, medical, and eligibility data from Humana Medicare Advantage patients diagnosed with schizophrenia (ICD-9-CM 295.xx) having continuous enrollment from 1/1/2010-12/31/2011.  QI-RE and data from 2010 were used to identify patients in the highest-risk quartile for future antipsychotic nonadherence (high-risk cohort).  The remaining patients in the study population (lower-risk) acted as the control cohort.  Antipsychotic adherence (proportion of days covered [PDC]), persistence (14 day gap allowance) and health care costs during 2011 were compared across both cohorts.  Student’s t-tests and chi-square tests were used for continuous and categorical variables, respectively. RESULTS: Relative to the control cohort (n=3,867), the high-risk cohort (n=1,139) was younger (mean age 54.6 vs. 55.4 years, p<0.041) and had more African Americans (26.0% vs. 17.8%, p<0.001).  During follow-up, mean PDC was 0.48 vs. 0.81 (p<0.001); persistence was 119.3 vs. 144.3 days (p<0.001); antipsychotic pharmacy costs were $1,950 vs. $3,933 (p<0.001); and, psychiatric-related medical costs were $4,938 vs. $4,452 (p=0.192) for high-risk and control cohorts, respectively.  CONCLUSIONS: Patients identified as high-risk for antipsychotic nonadherence by QI-RE had poorer adherence, shorter persistency, and lower antipsychotic pharmacy costs during the follow-up period relative to controls.  These results support the potential utility of QI-RE for quality improvement initiatives related to antipsychotic adherence in patients with schizophrenia.