Projecting the Long-Term Economic Impact of Once-Monthly Paliperidone Palmitate Versus Oral Atypical Antipsychotics in Medicaid Patients with Schizophrenia

Khoury, Antoine C. El; Pilon, Dominic; Morrison, Laura; Shak, Nina; Llaneza, Amanda; Kim, Edward; Lefèbvre, Patrick

doi:10.18553/jmcp.2020.26.2.176

Cited by 11 publications

(4 citation statements)

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“… 27 Furthermore, a subanalysis from the present study, conducted in patients with at least 1 prior hospitalization, reported that switching from oral RIS/PALI to PP1M may significantly improve HRU and provide potential cost savings in VHA database members with schizophrenia. 28 …”

Section: Discussionmentioning

confidence: 99%

Healthcare Resource Utilization and Costs Among Patients With Schizophrenia Switching From Oral Risperidone/Paliperidone to Once-Monthly Paliperidone Palmitate: A Veterans Health Administration Claims Analysis

Patel

Khoury

Huang

et al. 2020

Current Therapeutic Research

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Background Schizophrenia is associated with high health care resource utilization and treatment costs. Objective This study compared treatment patterns, health care resource utilization, and medical costs before and after a switch from oral antipsychotic drug (risperidone or paliperidone [RIS/PALI]) therapy to the long-acting injectable once-monthly paliperidone palmitate (PP1M) in patients with schizophrenia. Methods Data for adult patients (aged ≥18 years) with at least 1 diagnosis of schizophrenia who initiated treatment with oral RIS/PALI ≥6 months before switching and had continuous health plan enrollment during the study period before and after the switch were extracted from the Veterans Health Administration database. Treatment patterns, health care resource utilization, and costs were compared between the period 6 or 12 months before and after switching directly from oral RIS/PALI to PP1M. Results The analysis included 676 and 493 patients in the 6-month and 12-month cohorts, respectively. Adherence to oral RIS/PALI during the 12 months preswitch was 11.0% and 22.1% as measured by proportion of days covered and medication possession ratio ≥80%, respectively. During the 12 months postswitch, adherence to PP1M was 27.0% and 35.9%, respectively. Among patients treated with oral RIS/PALI, from 12 months pre- to 12 months post-PP1M switch, fewer all-cause inpatient stays (2.2 vs 1.1, respectively; P < 0.05) and a shorter mean length of inpatient stay (28.1 and 14.0 days, respectively; P < 0.05) were observed. This pattern was similar for both the number of mental health– and schizophrenia-related inpatient stays and length of stay. Compared with 12 months pre-PP1M switch, significantly higher mean numbers of all-cause outpatient visits and pharmacy visits were observed at 12 months postswitch. In line with health care resource utilization findings, at 12 months pre- versus 12 months post-PP1M switch we observed decreases in all-cause inpatient stay costs ($41,886 vs $20,489; P < 0.05) and increases in outpatient visit costs ($22,005 vs $29,069; P < 0.05). Findings for the 6-month cohort followed a similar pattern. Conclusions Post-PP1M switch, a decrease in total medical costs fully offset an increase in pharmacy costs, resulting in similar total costs. The findings suggest potential economic benefits of switching patients with schizophrenia from oral RIS/PALI to PP1M in the Veterans Health Administration.

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Section: Discussionmentioning

confidence: 99%

Healthcare Resource Utilization and Costs Among Patients With Schizophrenia Switching From Oral Risperidone/Paliperidone to Once-Monthly Paliperidone Palmitate: A Veterans Health Administration Claims Analysis

Patel

Khoury

Huang

et al. 2020

Current Therapeutic Research

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“…Good medication adherence is the key to the effectiveness of drug treatment. Poor medication adherence will cause many problems in schizophrenic patients 9 , 10 . First, low medication compliance will lead to low efficacy and high relapse.…”

Section: Introductionmentioning

confidence: 99%

Influencing factors of medication adherence in schizophrenic patients: a meta-analysis

Guo

Liu

et al. 2023

Schizophr

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Medication adherence of schizophrenic patients is a growing public health problem. We conducted a meta-analysis on the influencing factors of medication compliance in schizophrenic patients. We searched PubMed, Embase, Cochrane Library, and Web Of Science for relevant articles published up to December 22, 2022. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess influencing factors. Egger’s test, funnel plot, the trim and fill method, and meta-regression analysis were used to assess publication bias. A total of 20 articles were included in the analysis. Twenty influencing factors were divided into seven categories: drug factors (OR = 1.96, 95% CI: 1.48–2.59), problem behavior (OR = 1.77, 95% CI: 1.43–2.19), income and quality of life (OR = 1.23, 95% CI: 1.08–1.39), personal characteristics (OR = 1.21, 95% CI: 1.14–1.30), disease factors (OR = 1.14, 95% CI: 1.98–1.21), support level (OR = 0.54, 95% CI: 0.42–0.70), and positive attitude and behavior (OR = 0.52, 95% CI: 0.45–0.62). This meta-analysis found that drug factors, disease factors, problem behavior, low income and quality of life, and factors related to personal characteristics appear to be risk factors for medication adherence in people with schizophrenia. And support level, positive attitude and behavior appear to be protective factors.

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“…Positive symptoms refer to a change in behaviour or thoughts characterised by hallucinations and delusions while negative symptoms represent diminution in emotions, thinking and movement (Van Os & Kapur, 2009). Effective therapies and treatments for managing schizophrenia aim to reduce relapse of these symptoms (El Khoury et al, 2020). Adherence to antipsychotic medication has become a crucial part of care in reducing experiences and symptoms of mental illness in Australia and internationally (Prerna & Ivan, 2020).…”

Section: Introductionmentioning

confidence: 99%

A scoping review: Treatment attitudes and adherence for adults with schizophrenia

Nyanyiwa

Peters

Murphy

2022

Journal of Clinical Nursing

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Aim and objectives This scoping review presents an exploration of literature on the relationship between treatment attitudes and adherence in adults experiencing schizophrenia. Background Strategies to address adherence and improve treatment outcomes are described in literature. However, adherence remains a challenge for people experiencing mental illness in practice. Transformational frameworks, evidence‐based practice and patient‐centred approaches have been established and implemented but non‐adherence incidence rates continue to rise among people with schizophrenia. Moreover, the relationship between treatment attitudes and adherence in adults diagnosed with schizophrenia remains unclear. Design A scoping review using the framework offered by Implementation Science, 5, 2010, 1. The PRISMA‐ScR checklist was used to ensure integrity of the review. Methods Four databases PsychINFO, Medline, Cochrane and CINAHL databases were searched for literature along with the reference lists of eligible sources. Original research, peer‐reviewed articles published between 2010 and 2020 in English language were included. Articles were included if study participants were adults with a diagnosis of schizophrenia or related psychosis. Methodological quality was evaluated using a quality assessment checklist, the Critical Appraisal Skills Programme tool. Results Ten articles were included in the study. Five main themes about treatment adherence emerged from the literature: (i) severity of symptoms, (ii) side effects, (iii) beliefs and attitudes, (iv) insight and (v) support and relationships. Conclusions This scoping review concluded that attitude influenced adherence to medication in people with schizophrenia. The five main themes reported directly influenced attitude, impacting on treatment adherence in people experiencing schizophrenia. This review makes recommendations for a person‐centred and recovery framework that aims to improve adherence. Relevance to clinical practice Nurses in all healthcare settings could use evidence‐based strategies to enhance treatment adherence in people with a range of physical and mental health conditions.

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Projecting the Long-Term Economic Impact of Once-Monthly Paliperidone Palmitate Versus Oral Atypical Antipsychotics in Medicaid Patients with Schizophrenia

Cited by 11 publications

References 44 publications

Healthcare Resource Utilization and Costs Among Patients With Schizophrenia Switching From Oral Risperidone/Paliperidone to Once-Monthly Paliperidone Palmitate: A Veterans Health Administration Claims Analysis

Healthcare Resource Utilization and Costs Among Patients With Schizophrenia Switching From Oral Risperidone/Paliperidone to Once-Monthly Paliperidone Palmitate: A Veterans Health Administration Claims Analysis

Influencing factors of medication adherence in schizophrenic patients: a meta-analysis

A scoping review: Treatment attitudes and adherence for adults with schizophrenia

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