TY - JOUR
T1 - Impact of switching to long-acting injectable antipsychotics on health services use in the treatment of schizophrenia
AU - Lachaine, Jean
AU - Lapierre, Marie Eve
AU - Abdalla, Nadine
AU - Rouleau, Alice
AU - Stip, Emmanuel
PY - 2015/3/1
Y1 - 2015/3/1
N2 - OBJECTIVE: To better understand the treatment patterns, persistence and compliance, resource use, and associated costs, of long-acting injectable antipsychotics (LAI-AP), using the Régie de l'assurance maladie du Québec database.METHOD: Patients with schizophrenia or schizoaffective disorder who were incident users of an LAI-AP prescribed between January 1, 2008, and March 31, 2012, were selected. Concomitant use of oral APs and treatment persistence and compliance with LAI-AP were analyzed. Patients were considered compliant if they had a medication possession ratio (MPR) of at least 0.80. Health care resource use (HCRU) and associated costs were analyzed during the year before and after LAI-AP initiation.RESULTS: A total of 1992 patients met the inclusion criteria. The average persistence with LAI-AP was 217.2 days (SD 144.2). The mean MPR with LAI-AP during the postinitiation year was 0.58 (SD 0.35), with 37.5% of patients being compliant. In the preinitiation year, 29.0% of patients were compliant with previous oral AP. In the pre- and postinitiation periods, 1484 and 958 patients had at least 1 hospitalization, and hospitalized days were reduced by one-half (P<0.001). Cost of HCRU, including medication, was significantly decreased from $24,382 (SD $27,234) to $13,090 (SD $16,987), respectively, in the pre- and postinitiation years (P<0.001).CONCLUSIONS: The initiation of an LAI-AP improved treatment compliance, compared with previous oral APs, resulted in significantly lower HCRU and costs. The primary drivers were the reduction in the occurrence and days of hospitalizations.
AB - OBJECTIVE: To better understand the treatment patterns, persistence and compliance, resource use, and associated costs, of long-acting injectable antipsychotics (LAI-AP), using the Régie de l'assurance maladie du Québec database.METHOD: Patients with schizophrenia or schizoaffective disorder who were incident users of an LAI-AP prescribed between January 1, 2008, and March 31, 2012, were selected. Concomitant use of oral APs and treatment persistence and compliance with LAI-AP were analyzed. Patients were considered compliant if they had a medication possession ratio (MPR) of at least 0.80. Health care resource use (HCRU) and associated costs were analyzed during the year before and after LAI-AP initiation.RESULTS: A total of 1992 patients met the inclusion criteria. The average persistence with LAI-AP was 217.2 days (SD 144.2). The mean MPR with LAI-AP during the postinitiation year was 0.58 (SD 0.35), with 37.5% of patients being compliant. In the preinitiation year, 29.0% of patients were compliant with previous oral AP. In the pre- and postinitiation periods, 1484 and 958 patients had at least 1 hospitalization, and hospitalized days were reduced by one-half (P<0.001). Cost of HCRU, including medication, was significantly decreased from $24,382 (SD $27,234) to $13,090 (SD $16,987), respectively, in the pre- and postinitiation years (P<0.001).CONCLUSIONS: The initiation of an LAI-AP improved treatment compliance, compared with previous oral APs, resulted in significantly lower HCRU and costs. The primary drivers were the reduction in the occurrence and days of hospitalizations.
UR - http://www.scopus.com/inward/record.url?scp=85018208393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018208393&partnerID=8YFLogxK
M3 - Article
C2 - 25886679
AN - SCOPUS:85018208393
SN - 0706-7437
VL - 60
SP - S40-S47
JO - Canadian Journal of Psychiatry
JF - Canadian Journal of Psychiatry
IS - 3
ER -
