Effects of Paliperidone Palmitate on Healthcare Utilization and Costs for Patients with Schizophrenia: A Claim-based Mirror-image Study in South Korea
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Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results: Patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p ＜ 0.0001) and the associated costs increasing by USD 1,497.15 (p ＜ 0.0001). The number of admission days was reduced by 11.33 after starting PP treatment (p ＜ 0.0001) and the associated costs were reduced by USD 1,220.75 (p ＜ 0.0001). However, admission cost savings were different according to patients’ oral drug compliance. The daily dosages for benztropine, procyclidine, and propranolol decreased, showing that there were fewer side-effects after PP-treatment (p ＜ 0.0001). Conclusion: Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.
Abstract
Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results: Patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p ＜ 0.0001) and the associated costs increasing by USD 1,497.15 (p ＜ 0.0001). The number of admission days was reduced by 11.33 after starting PP treatment (p ＜ 0.0001) and the associated costs were reduced by USD 1,220.75 (p ＜ 0.0001). However, admission cost savings were different according to patients’ oral drug compliance. The daily dosages for benztropine, procyclidine, and propranolol decreased, showing that there were fewer side-effects after PP-treatment (p ＜ 0.0001). Conclusion: Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.
참고문헌 (26)
- "World Health Organization health topics: schizophrenia" (2015)[URL]
- Chien WT, "Current approaches to treatments for schizophrenia spectrum disorders, part I : an overview and medical treatments", Neuropsychiatr Dis Treat, 9, pp.1311~1332 (2013)
- Zhang F, "Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia", Neuropsychiatr Dis Treat, 11, pp.657~668 (2015)
- Morrato EH, "Comparative effectiveness of injectable paliperidone palmitate versus oral atypical antipsychotics : early postmarketing evidence", J Comp Eff Res, 4, pp.89~99 (2015)
- Einarson TR, "Pharmacoeconomic analysis of paliperidone palmitate for treating schizophrenia in Greece", Ann Gen Psychiatry, 11, pp.18~ (2012)
- Thieda P, "An economic review of compliance with medication therapy in the treatment of schizophrenia", Psychiatr Serv, 54, pp.508~516 (2003)
- Novick D, "Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia", Psychiatry Res, 176, pp.109~113 (2010)
- Kishimoto T, "Long-acting injectable versus oral antipsychotics in schizophrenia : a systematic review and meta-analysis of mirror-image studies", J Clin Psychiatry, 74, pp.957~965 (2013)
- So-Young Oh, "The Impact of Paliperidone Palmitate on Hospitalization in Patients with Schizophrenia: A Retrospective Mirror-image Study", Clinical Psychopharmacology and Neuroscience, 17(4), pp.531~536 (2019), 대한정신약물학회[DOI]
- Baser O, "Healthcare utilization and costs of Veterans Health Administration patients with schizophrenia treated with paliperidone palmitate long-acting injection or oral atypical antipsychotics", J Med Econ, 18, pp.357~365 (2015)
- Pesa JA, "Costs and resource utilization among Medicaid patients with schizophrenia treated with paliperidone palmitate or oral atypical antipsychotics", Drugs Real World Outcomes, 2, pp.377~385 (2015)
- Pesa JA, "Health care resource utilization and costs of California Medicaid patients with schizophrenia treated with paliperidone palmitate once monthly or atypical oral antipsychotic treatment", Curr Med Res Opin, 33, pp.723~731 (2017)
- Jiang Y, "Estimating the impact of adherence to and persistence with atypical antipsychotic therapy on health care costs and risk of hospitalization", Pharmacotherapy, 35, pp.813~822 (2015)
- Choon JWY, "Real-world evidence of improved healthcare utilization in patients with schizophrenia or schizoaffective disorder after early treatment of paliperidone palmitate once-monthly treatment in Hong Kong", J Med Econ, 22, pp.273~279 (2019)
- Chiou CF, "The cost reduction in hospitalization associated with paliperidone palmitate in the People's Republic of China, Korea, and Malaysia", Neuropsychiatr Dis Treat, 11, pp.1989~1994 (2015)
- El Khoury AC, "The prospective economic impact of once monthly paliperidone palmitate versus oral atypical antipsychotics in Medicaid patients with schizophrenia", Curr Med Res Opin, 35, pp.395~405 (2019)
- Kozma CM, "Changes in schizophrenia-related hospitalization and ER use among patients receiving paliperidone palmitate : results from a clinical trial with a 52-week open-label extension(OLE)", Curr Med Res Opin, 27, pp.1603~1611 (2011)
- Xiao Y, "Impact of paliperidone palmitate versus oral atypical antipsychotics on healthcare outcomes in schizophrenia patients", J Comp Eff Res, 4, pp.579~592 (2015)
- Ren XS, "Evaluation of health services use following the initiation of risperidone long-acting therapy among schizophrenia patients in the veterans health administration", J Clin Pharm Ther, 36, pp.383~389 (2011)
- 정석훈, "리스페리돈 장기 지속형 주사제의 효용과 안정성：12주 다기관 경구 항정신병약물로부터 교체연구", 대한정신약물학회지, 16(2), pp.109~120 (2005), 대한정신약물학회
- Morris MT, "Long-acting injectable paliperidone palmitate : a review of efficacy and safety", Psychopharmacol Bull, 47, pp.42~52 (2017)
- Bossie CA, "Onset of efficacy and tolerability following the initiation dosing of long-acting paliperidone palmitate : post-hoc analyses of a randomized, double-blind clinical trial", BMC Psychiatry, 11, pp.79~ (2011)
- Gopal S, "Efficacy and safety of paliperidone palmitate in adult patients with acutely symptomatic schizophrenia : a randomized, double-blind, placebo-controlled, dose-response study", Int Clin Psychopharmacol, 25, pp.247~256 (2010)
- Kramer M, "Paliperidone palmitate, a potential long-acting treatment for patients with schizophrenia. Results of a randomized, double-blind, placebo-controlled efficacy and safety study", Int J Neuropsychopharmacol, 13, pp.635~647 (2010)
- Nasrallah HA, "A controlled, evidence-based trial of paliperidone palmitate, a long-acting injectable antipsychotic, in schizophrenia", Neuropsychopharmacology, 35, pp.2072~2082 (2010)
- Pandina GJ, "A randomized, placebo-controlled study to assess the efficacy and safety of 3 doses of paliperidone palmitate in adults with acutely exacerbated schizophrenia", J Clin Psychopharmacol, 30, pp.235~244 (2010)