Baseline characteristics and treatment patterns of patients with schizophrenia initiated on once-every-three-months paliperidone palmitate in a real-world setting

Abstract

Patients initiated on PP3M demonstrated decreased HRU and increased adherence in quarters closer to PP3M initiation, and were persistent on their PP3M treatment.

Adherence, Healthcare Resource Utilization, and Costs in Medicaid Beneficiaries with Schizophrenia Transitioning from Once-Monthly to Once-Every-3-Months Paliperidone Palmitate

“…They showed similar results in baseline quarters preceding PP3M initiation, with an increase in the proportion of patients with a PDC of ≥ 0.80 from 71.3% at the fourth quarter to 82.3% at the first quarter prior to PP3M initiation (compared to an increase from 66.8 to 84.6% in our study). Similar to the findings of the current study, Joshi et al [22] demonstrated in their study a decrease in the monthly number of emergency room visits in quarters preceding PP3M transition (from 0.08 to 0.06 per month). This finding and findings from the current study are consistent with the requirement from the prescribing guidelines that patients be adequately treated with PP1M prior to the transition to PP3M.…”

“…It is also possible that some of the initial claims for PP1M were not captured in the data (e.g., samples). Nevertheless, findings are consistent across both studies, as > 50% of patients transitioned from PP1M to PP3M as per prescribing guidelines [22].…”

“…CI confidence interval, HRU healthcare resource utilization, NE not evaluable, PP3M once-every-3-months paliperidone palmitate as 95.6% of patients had an MPR of ≥ 0.80, and 81.7% of patients had a 6-month PDC of ≥ 0.80. The algorithm used in the current study and in Joshi et al [22] to define adequate treatment with PP1M prior to transition to PP3M has been developed to mimic the PP3M clinical trial protocol [20,21]. However, treating healthcare providers may have clinical reasons for not conforming with the guidelines in certain circumstances where individualized patient care is required.…”

“…A recent study by Joshi et al [22] assessed patients who transitioned from PP1M to PP3M and examined patients' baseline characteristics and treatment patterns over a period MPR medication possession ratio, PDC proportion of days covered, PP1M once-monthly paliperidone palmitate, PP3M once-every-3-months paliperidone palmitate, SD standard deviation a Continuous PP3M therapy was defined as having a gap of no more than 45 days between the end of supply of a PP3M claim and the start of a new PP3M claim, starting from the index date b Among patients with more than three PP3M claims and at least 4 months of follow-up between claims c MPR was calculated among patients with at least two claims of PP3M d PDC was calculated as the sum of the number of unique days during which the patient had PP3M, divided by a fixed time interval of 1 year before the transition to PP3M. Patients in this study had similar characteristics as the patients in our sample (e.g., 33.9% were females).…”

“…Prior to FDA approval in 2015, the safety and efficacy of PP3M were demonstrated in two double-blind, randomized clinical trials [20,21]. While patients' characteristics and treatment patterns during the period prior to PP3M initiation have been assessed [22], there is a need to assess the impact of transitioning to PP3M on treatment adherence, healthcare resource utilization (HRU), and costs. This study aims to evaluate the variation of these outcomes as the transition approaches and to compare them before and after PP3M initiation in a real-world setting.…”