Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population.

Abstract

Aim: To compare adherence, healthcare utilization and costs among real world, Medicare-eligible patients with schizophrenia using long-acting injectable paliperidone palmitate (PP) versus oral atypical antipsychotics. Patients &methods: Historical cohort study used Medicare Advantage claims data. Inverse probability of treatment weighting was applied to adjust for baseline differences. 12-month adherence, healthcare utilization and costs were compared. Results: Patients using PP were more adherent (proportion of days covered ≥0.8; 48.1 vs 32.6%; p <0.001), had lower odds of hospitalization (odds ratio [OR]: 0.81; 95%CI:0.68-0.96) and lower medical costs ($11,095; 95%CI: $10,374-11,867 vs $15,551; 95%CI: $14,584-16,583), but higher pharmacy costs ($14,787; 95%CI: $14,117-15,488 vs $5781; 95%CI: $5530-6043). Conclusion: Compared with patients using oral atypical antipsychotics, PP had lower hospitalizations and medical costs with greater medication adherence accompanied by higher pharmacy costs.