Abstract
No studies have assessed the economic impact of extrapyramidal symptoms due to atypical antipsychotics in schizophrenia. To assess healthcare resource use and medical costs associated with extrapyramidal symptoms in patients with schizophrenia. A retrospective analysis of Marketscan® Medicaid Multi-State Database (2004–2009) was conducted. Patients with schizophrenia and newly initiated on an AAP were included. Patients with and without extrapyramidal symptoms were matched using propensity-score matching. Healthcare utilization and costs were assessed in the 12-month follow-up period using logistic and two-part (gamma) regression models. Of 4,621 patients, 583 (12.6 %) had extrapyramidal symptoms. Patients with extrapyramidal symptoms had significantly more schizophrenia-related and all-cause hospitalizations and schizophrenia-related emergency room visits, as well as significantly higher schizophrenia-specific and all-cause total healthcare, inpatient, and prescription drug costs compared to patients without extrapyramidal symptoms. Extrapyramidal symptoms in patients with schizophrenia is associated with increased healthcare resource utilization and higher medical costs.
Highlights
No studies have assessed the economic impact of extrapyramidal symptoms due to atypical antipsychotics in schizophrenia
To assess healthcare resource use and medical costs associated with extrapyramidal symptoms in patients with schizophrenia
Schizophrenia is a chronic, debilitating psychiatric disorder characterized by deficits in thought processes, perceptions, and emotional responsiveness, affecting approximately 1 % of the United States (US) population (NIMH 2012)
Summary
Schizophrenia is a chronic, debilitating psychiatric disorder characterized by deficits in thought processes, perceptions, and emotional responsiveness, affecting approximately 1 % of the United States (US) population (NIMH 2012). The use of first generation or ‘‘conventional’’ APs has been hindered by intolerability, extrapyramidal symptoms (EPS), which are risk factors for reduced adherence and persistence to medications (Pierre 2005). A few studies have shown that adverse events (AEs) are common in the treatment of schizophrenia and that they are associated with higher direct and indirect medical costs (Nasrallah 2002). In a recent study of 876 patients with schizophrenia using AP medications, 86 % reported experiencing at least one AE and 58 % were not completely adherent to their medication, mainly due to AEs (DiBonaventura et al 2012). Little is known about the pharmacoeconomic implications specific to the treatment of emergent EPS in patients with schizophrenia
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