Health Care Cost in Patients With Schizophrenia Treated With Brexpiprazole Versus Other Oral Atypical Antipsychotic Therapy

Abstract

Purpose: Brexpiprazole is an oral atypical antipsychotic (OAA) for the treatment of schizophrenia (SCZ). This study compared all-cause and psychiatric inpatient hospitalization and medical costs in adult patients with SCZ newly treated with brexpiprazole versus other US Food and Drug Administratione approved OAAs in a real-world setting.Methods: This retrospective cohort study analyzed data from: (1) the IBM MarketScan Commercial and Medicare Supplemental databases, and the MarketScan Multi-State Medicaid database; and (2) the de-identified Optum Clinformatics Datamart. Adult patients were identified if they had SCZ and initiated either brexpiprazole or another OAA during the study identification period (

Second-Generation Antipsychotics’ Effectiveness and Tolerability: A Review of Real-World Studies in Patients with Schizophrenia and Related Disorders

“…Finally, when brexpiprazole treatment was examined compared to other SGAs, it was found to be associated with fewer psychiatric hospitalizations per year than paliperidone and quetiapine. No significant differences in other efficacy measures emerged between patients treated with brexpiprazole and those with other SGAs [ 63 ].…”

“…However, patients treated with lurasidone displayed greater adherence when compared to patients treated with other SGAs [ 60 ]. Furthermore, one study analyzed the efficacy of brexpiprazole, and no significant differences emerged when treated patients were compared with those treated with other SGAs [ 63 ].…”

<p>Brexpiprazole for the Treatment of Schizophrenia in Adults: An Overview of Its Clinical Efficacy and Safety and a Psychiatrist’s Perspective</p>

“… Previous high-dose antipsychotic therapy (Chlorpromazine-equivalent doses >800 mg) is an independent risk factor for brexpiprazole discontinuation in patients with schizophrenia or schizoaffective disorder. Yan et al 29 ≥ 52 Follow-up Schizophrenia 6254 176 Ziprasidone (391) Paliperidone (453) Lurasidone (523) Aripiprazole (786) Quetiapine (1234) Olanzapine (1264) Retrospective cohort study. Brexpiprazole users had the lowest mean psychiatric costs among all oral atypical antipsychotic users ($12,013).…”

“…Yan et al 29 conducted a retrospective, real-world cohort study to compare all-cause and psychiatric hospitalization and medical costs in patients newly treated with brexpiprazole versus other atypical antipsychotics by drawing on the available US insurance claims data. This study has demonstrated that all-cause total costs and all-cause medical costs did not differ across atypical antipsychotic groups; however, patients treated with brexpiprazole had the lowest mean psychiatric costs of all patients prescribed atypical antipsychotics ( Table 2 ).…”

“…To date, three randomized, double-blind, placebocontrolled trials (RCTs) of brexpiprazole have been conducted in patients with schizophrenia (Table 2). 11,[17][18][19][20][21][22][23][24][25][26][27][28][29] Of these, two Phase III RCTs comparing brexpiprazole 2 mg/ day, 4 mg/day and placebo were included in a pooled analysis conducted by Correll et al, 17 which demonstrated that the mean change from baseline in the Positive and Negative Syndrome Scale (PANSS) total score was significantly different at −18.79 and −20.01 (P = 0.0004 and P < 0.0001), respectively, in those receiving brexpiprazole 2 mg/day (n = 359) and 4 mg/day (n = 359), compared to −13.3 in those receiving placebo (n = 358). It was also demonstrated that the positive subscale was significantly improved at −6.06 and −6.76 (P = 0.0107 and P < 0.0001), respectively, in those receiving brexpiprazole 2 mg/day and 4 mg/day, compared to −4.74 in those receiving placebo, with the negative subscale score being also significantly improved at −3.51 and −3.59 (P = 0.0015 and P = 0.0007), respectively, compared to −2.31 in those receiving placebo.…”