Recent Patterns of Relapse and Associated Costs in Schizophrenia Patients Initiating Atypical Antipsychotics

BACKGROUND: Data on the burden associated with schizophrenia relapse within the new treatment landscape is scarce. This study aims to identify relapse in schizophrenia and update their associated healthcare costs.

METHODS: Medicaid data (2010-2018) from IA, KS, MS, MO, NJ, and WI was used to identify adults with schizophrenia receiving atypical antipsychotics (AP). The first schizophrenia diagnosis following AP initiation defined the index. Relapse episodes were identified based on (1) weeks during the ≥2 years post-index associated with high cost increase from baseline (12-month pre-index) and (2) high absolute weekly cost. A compound score was calculated, where the 54% of patients were considered relapsers. Healthcare resource use (HRU) and costs ($2018 USD) of relapsers during baseline and relapse episodes were compared using incidence rate ratios (IRRs) and bootstrap methods.

RESULTS: In total, 3,625 relapsers with a mean of 5.8 relapses per patient were identified. The mean relapse duration was 29.1 weeks and the mean healthcare cost was $28,258 per relapse over an average follow-up of 4.0 years. Compared with baseline, HRU during relapses was significantly greater in pharmacy, institutional visits (hospitalizations, emergency department visits), home, and outpatient visits, with IRRs ranging from 1.9-3.1 (all p<0.0001). Relapse was associated with an incremental cost increase of $1,866 (p<0.0001) weekly, with institutional visits representing 75% of the increase.

CONCLUSIONS: Significant cost increases were observed with relapse in schizophrenia, driven mainly by institutional visits. These findings provide updated data on the burden associated with schizophrenia relapse.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.