COMPARING HEALTHCARE RESOURCE UTILIZATION AND COSTS AMONG SCHIZOPHRENIC PATIENTS WHO INITIATED TYPICAL VS. ATYPICAL LONG-ACTING INJECTABLES IN THE U.S. VETERAN POPULATION

Author(s)

Baser O1, Kariburyo MF2, Du J2, Xie L2
1STATinMED Research, Columbia University, New York, NY, USA, 2STATinMED Research, Ann Arbor, MI, USA

OBJECTIVES: To evaluate healthcare resource utilization and costs among schizophrenic patients who initiated typical and atypical long-acting injectables (LAIs) in the U.S. veteran population. METHODS: Using the Veterans Health Administration (VHA) Medical SAS datasets, patients with ≥1 pharmacy claim for LAIs were identified from 01OCT2005 through 30SEPT2012. The first LAI date was designated as the index date. Patients were required to be age ≥18 years, have continuous health plan enrollment for 12 months pre-index date and a schizophrenia diagnosis (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 295.xx) during the study period. Patient data was observed until the earlier date of death or the end of the study period, and patients were assigned to typical LAI (fluphenazine, haloperidol, perphenazine) or atypical LAI (aripiprazole, olanzapine, paliperidone, risperidone) antipsychotic cohorts. All-cause (follow-up) and psychiatric disorder-related healthcare resource utilization and costs were assessed. Follow-up health care costs were adjusted to per-patient-per-month. The generalized linear model (GLM) was used to assess cost and utilization differences among the cohorts. RESULTS: A total of 4,796 patients were identified (Typical LAI cohort: N=1,941; Atypical LAI cohort: N=2,855). Typical LAI patients were older (age 53.81 vs. 50.94 years, p<0.0001) and more likely to be black (34.47% vs. 28.27%, p<0.0001) than atypical LAI patients. After adjusting for baseline differences using GLM, more patients prescribed typical LAIs had all-cause emergency room [ER] visits (61.66% vs. 58.11%, p=0.024) and inpatient stays (63.11% vs. 59.00%, p=0.008) and psychiatric disorder-related ER visits (33.83% vs. 30.05%, p=0.011) than those prescribed atypical LAIs. However, typical LAI patients incurred lower all-cause pharmacy ($197 vs. $433, p<0.001), total ($2,850 vs. $3,073, p=0.048) and psychiatric disorder-related total costs ($1,615 vs. $1,624, p=0.908) than atypical LAI patients. CONCLUSIONS: Although patients who initiated typical LAIs had high healthcare resource utilization, their economic burden was lower compared to those who initiated atypical LAIs.

Conference/Value in Health Info

2015-05, ISPOR 2015, Philadelphia, PA, USA

Value in Health, Vol. 18, No. 3 (May 2015)

Code

PMH26

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Mental Health

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