Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population

Abstract

Compared with patients using oral atypical antipsychotics, PP had lower hospitalizations and medical costs with greater medication adherence accompanied by higher pharmacy costs.

Time to Treatment Discontinuation in German Patients with Schizophrenia: Long-Acting Injectables versus Oral Antipsychotics

“…Similar German studies comparing persistence of LAIs and OAPs are unavailable. However, our results are in line with observational studies of varying sample sizes conducted in the USA [20,21,25,29,43]. Greene et al [20] analyzed Medicaid data and reported that a greater proportion of LAI users than OAP users had PDC ≥ 0.8 after a year of follow-up (33.9% vs. 25.5%; p < 0.001).…”

“…Pilon et al [25] reported the odds of being adherent to the prescribed treatment (PDC ≥ 0.8) were higher among users of secondgeneration antipsychotic (SGA) LAIs compared with OAP users (odds ratio [OR] 1.28, 95% CI 1.18-1.40; p < 0.001). Joshi et al [29] reported similar results as users of paliperidone palmitate LAI were more adherent than OAP users (PDC ≥ 0.8: 48.1% vs. 32.6%; p < 0.001).…”

“…Usage of long-acting injectable antipsychotics (LAIs) is one of the strategies employed to improve adherence in patients with schizophrenia, as LAIs have been shown to increase medication adherence and reduce hospitalization [17][18][19][20][21][22][23], as well as to be more cost-effective compared with oral antipsychotics (OAPs) [23][24][25][26][27][28]. Recent studies have evaluated the difference in medication adherence between LAIs and OAPs using claims data from the USA [20,25,29]. Greene et al [20] reported that LAI users had a higher mean proportion of days covered (PDC) than OAP users (0.55 vs. 0.50; p < 0.001), while OAP users had a greater risk of treatment discontinuation (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.12-1.28; p < 0.001).…”

The effect of long‐acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta‐analysis

“…Exceptions were a study (Mohamed et al 2009) reporting lower medication adherence and three studies (Schreiner et al 2014;Stankovi c & Ille 2013;Weiden et al 2012) finding no differences in LAI compared with oral users. Eight studies (Anderson et al 2017;Greene et al 2018;Joshi et al 2018aJoshi et al , 2018cLefebvre et al 2017;Manjelievskaia et al 2018;Pilon et al 2017bPilon et al , 2017cYan et al 2018;Young-Xu et al 2016) in the pooled analysis showed no differences between LAIs and orals regarding the proportion of patients that had 80% or more PDC (n = 59042, 95% CI = 0.804-3.695, P < 0.162; s 2 = 1.142, I 2 = 94.605%, Q = 129.759, df = 7, P < 0.001) (Figure 2). The true effect in 95% of all comparable populations fell within the prediction interval 0.16-23.50 (see supplemental materials).…”

“…Changes in healthcare costs were reported in 15 studies (Baser et al 2015;Fan et al 2018;Joshi et al 2018aJoshi et al , 2018cLafeuille et al 2015Lafeuille et al , 2018Lefebvre et al 2017;Manjelievskaia et al 2018;Moore et al 1998;Pesa et al 2015;Pilon et al 2017bPilon et al , 2017cXiao et al 2015Xiao et al , 2016Young-Xu et al 2016) (Table 5).…”