Outcomes Related to Transition to Once-Every-Three-Monthly Paliperidone Palmitate Among Veterans With Schizophrenia
This poster was presented at the 31st annual Psych Congress, held Oct. 25-28, 2018, in Orlando, Florida.
Background: There is limited literature on treatment patterns, healthcare resource utilization (HRU) and costs among patients who transition from paliperidone palmitate once-monthly (PP1M) to once-every-3-monthly (PP3M) in the real-world setting.
Objective: To compare treatment patterns, HRU and costs 12-months pre- and post- transition to PP3M among Veterans with schizophrenia.
Methods: Schizophrenia patients (aged ≥18) who initiated PP1M and transitioned as per on-label criteria to PP3M (no treatment gap of >45 days in PP1M during the 4 months prior, same dose strength of the last 2 PP1M claims, and appropriate dose conversion from last PP1M to first PP3M claim) from January 2015 to March 2017 were included from Veterans’ Health Administration database. The first transition date to PP3M was identified as the index date. Patients required 12-months pre- and post- PP3M continuous health plan eligibility. Outcomes were compared using the Wilcoxon-signed rank and Mc-Nemar test, appropriately.
Results: The study included 122 patients (mean age: 54 years). During pre-PP3M transition, 64.8% of the patients were adherent (proportion of days covered ≥80%) to PP1M. Comparison of outcomes from pre- and post- PP3M transition resulted in: no difference in adherence to antipsychotics (90.2% vs 85.3%, p=0.2999); significantly lower all-cause outpatient costs ($27,221 vs $22,356, p=0.0033); higher pharmacy costs ($16,349 vs $17,003, p=0.0076); lower total medical costs ($35,834 vs $28,900, p=0.0257); and no significant difference in total costs ($52,183 vs $45,903, p=0.3118).
Conclusion: Transitioning from PP1M to PP3M may improve clinical outcomes in VA patients with schizophrenia while remaining cost neutral.
