OBJECTIVES : To compare treatment patterns and health resource utilization (HRU) in patients with schizophrenia treated with once-monthly paliperidone palmitate (PP) versus oral atypical antipsychotics (OAAs) with a focus on young adults (18-35 years).

METHODS : Adult patients with a diagnosis of schizophrenia and ≥2 claims for PP or OAA from 1/1/2010 to 12/31/2014 were selected from the Truven Health MarketScan® Medicaid database. Index date was assigned as the date of the first observed claim of PP or OAA. Patients were required to be continuously enrolled for ≥12 months pre-and post-index date, with no PP or OAA use during the 12-month pre-index period. Treatment patterns and HRU outcomes for patients aged 18-35 were compared between PP and OAA treatment groups following inverse probability of treatment weighting (IPTW) to adjust for potential differences.

RESULTS : A total of 15,598 patients met the study criteria, among which 6,250 were aged 18-35 (439 PP and 5,811 OAA). After IPTW, the young adult PP and OAA cohorts were comprised of 3,095 and 3,155 patients, respectively. During the 12-month post-index period, PP patients had a higher duration of continuous treatment exposure (168.2 vs. 132.5 days, p=0.004) and better adherence on the index medication (proportion of days covered [PDC]≥ 80%: 19.0% vs.17.1%, p<0.049). Furthermore, young adult patients treated with PP were 37% less likely to have an all-cause inpatient admission (odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.53-0.74) and 33% less likely to have an ER visit (OR: 0.67, 95% CI: 0.55-0.81) compared to OAA young adult patients, but 27% more likely to have an all-cause outpatient office visit (OR: 1.27, 95% CI: 1.02–1.56).

CONCLUSIONS : This analysis suggests that Medicaid schizophrenia patients aged 18-35 treated with PP are associated with higher medication adherence and fewer hospitalizations as compared to patients treated with OAAs.