Atypical antipsychotic therapy for treatment of schizophrenia in Hong Kong Chinese patients - a cost analysis

Law, Wai‐Lun; Huang, Hui; Young, W M; You, JH

doi:10.5414/cpp45264

Cited by 8 publications

(2 citation statements)

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“…Unlike inpatient services, the number of outpatient visits for the atypical cohort was significantly higher than the typical cohort. These results are similar to previous findings reported in the literature showing that atypical antipsychotic therapy resulted in higher resource utilization in outpatient care, which may indicate closer interactions between patients and psychiatrists and further lead to better adherence and lower relapse rates [ 31 , 32 ].…”

Section: Discussionsupporting

confidence: 90%

Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Jiang

et al. 2015

BMC Health Serv Res

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BackgroundIt is uncertain whether the extra acquisition costs of atypical antipsychotics over typical antipsychotics are offset by their other reduced resource use especially in hospital services in China. This study compared the psychiatric-related health care resource utilization and direct medical costs for patients with schizophrenia initiating atypical or typical antipsychotics in Tianjin, China.MethodsData were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2008–2010). Adult patients with schizophrenia with ≥1 prescription for antipsychotics after ≥90-day washout and 12-month continuous enrollment after first prescription was included. Psychiatric-related resource utilization and direct medical costs of the atypical and typical cohorts were estimated during the 12-month follow-up period. Logistic regressions, ordinary least square (OLS), and generalized linear models (GLM) were employed to estimate differences of resource utilization and costs between the two cohorts. One-to-one propensity score matching was conducted as a sensitivity analysis.Results1131 patients initiating either atypical (N = 648) or typical antipsychotics (N = 483) were identified. Compared with the typical cohort, the atypical cohort had a lower likelihood of hospitalization (45.8% vs. 56.7%, P < 0.001; adjusted OR: 0.58, P < 0.001) over the follow-up period. Medication costs for the atypical cohort were higher than the typical cohort ($438 vs. $187, P < 0.001); however, their non-medication medical costs were significantly lower ($1223 vs. $1704, P < 0.001). The total direct medical costs were similar between the atypical and typical cohorts before ($1661 vs. $1892, P = 0.100) and after matching ($1711 vs. 1868, P = 0.341), consistent with the results from OLS and GLM models for matched cohorts.ConclusionsThe atypical cohort had similar total direct medical costs compared to the typical cohort. Higher medication costs associated with atypical antipsychotics were offset by a reduction in non-medication medical costs, driven by fewer hospitalizations.

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Section: Discussionsupporting

confidence: 90%

Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Jiang

et al. 2015

BMC Health Serv Res

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“…Although this is the average age for the patients with schizophrenia rather than the onset age, the average age is still higher than that obtained in other results of claims data from Taiwan (39.7 years), Hong Kong (43.0 years), and Germany (48.0 years). 17 , 25 , 27 The reason for the prevalence of older patients in our sample is that the People’s Republic of China UEBMI system includes people who are employed or retired; hence, the population that dropped out of paid employment at an early age due to the onset of schizophrenia is not captured in our data.…”

Section: Discussionmentioning

confidence: 99%

Health care resource use and direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China

Wu¹,

He²,

Liu³

et al. 2015

NDT

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ObjectiveInformation concerning the treatment costs of schizophrenia is scarce in People’s Republic of China. The aims of this study were to quantify health care resource utilization and to estimate the direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China.MethodsData were obtained from the Tianjin Urban Employee Basic Medical Insurance (UEBMI) database. Adult patients with ≥1 diagnosis of schizophrenia and 12-month continuous enrollment after the first schizophrenia diagnosis between 2008 and 2009 were included. Both schizophrenia-related, psychiatric-related, and all-cause related resource utilization and direct medical costs were estimated.ResultsA total of 2,125 patients were included with a mean age of 52.3 years, and 50.7% of the patients were female. The annual mean all-cause costs were $2,863 per patient with psychiatric-related and schizophrenia-related costs accounting for 84.1% and 62.0% respectively. The schizophrenia-related costs for hospitalized patients were eleven times greater than that of patients who were not hospitalized. For schizophrenia-related health services, 60.8% of patients experienced at least one hospitalization with a mean (median) length of stay of 112.1 (71) days and a mean cost of $1,904 per admission; 59.0% of patients experienced at least one outpatient visit with a mean (median) number of visits of 6.2 (4) and a mean cost of $42 per visit during the 12-month follow-up period. Non-medication treatment costs were the most important element (45.7%) of schizophrenia-related costs, followed by laboratory and diagnostic costs (19.9%), medication costs (15.4%), and bed fees (13.3%).ConclusionThe costs related to the treatment of patients with schizophrenia were considerable in Tianjin, People’s Republic of China, driven mainly by schizophrenia-related hospitalizations. Efforts focusing on community-based treatment programs and appropriate choice of drug treatment have the potential to reduce the use of inpatient services and may lead to better clinical and economic outcomes in the management of patients with schizophrenia in People’s Republic of China.

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Pharmacotherapy for schizophrenic inpatients in East Asia – Changes and challenges

Shinfuku¹,

Tan²

2008

International Review of Psychiatry

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Prescription patterns of antipsychotic drugs differ greatly country by country and have recently experienced rapid changes. Our survey shows second generation antipsychotics are frequently used in East Asia. The introduction of SGA resulted in the combined use of first generation psychotropic drugs (FGA) and SGA in East Asia. These changing prescription patterns have created many challenges for psychiatrists in East Asia.

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Atypical antipsychotic therapy for treatment of schizophrenia in Hong Kong Chinese patients - a cost analysis

Cited by 8 publications

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Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Health care resource use and direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China

Pharmacotherapy for schizophrenic inpatients in East Asia – Changes and challenges

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Atypical antipsychotic therapy for treatment of schizophrenia in Hong Kong Chinese patients - a cost analysis

Cited by 8 publications

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Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China

Health care resource use and direct medical costs for patients with schizophrenia in Tianjin, People&rsquo;s Republic of China

Pharmacotherapy for schizophrenic inpatients in East Asia – Changes and challenges

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Health care resource use and direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China