PMH25 REAL-WORLD EVIDENCE INVESTIGATION ON HEALTHCARE UTILIZATION AND COST AMONG NEGATIVE SYMPTOM PATIENTS AND NON-NEGATIVE SYMPTOM PATIENTS WITH SCHIZOPHRENIA IN THE US

Abstract

Patients with negative symptoms of schizophrenia (NSS) experience lack of pleasure and motivation, diminished emotional expressivity and social withdrawal. These impairments persist throughout an individual’s lifetime. This study investigated if NSS patients utilize more health care services and are more expensive to treat than non-negative symptom of schizophrenia (NNSS) patients. Data were obtained from the Decision Resources Group (DRG) Real World Evidence Data Repository US database. Using the DSM-IV/ICD-9 code for Schizophrenia Residual Type or with the specifier With Prominent Negative Symptoms, NSS and NNSS patients were defined as having either ≥2 negative symptom codes or no negative symptoms, respectively, between 2014Q1-2017Q4. NSS and NNSS patients were age and gender matched. Univariate and multivariate models were used to estimate healthcare utilization and cost. Gamma log-link models to estimate cost were adjusted for age, gender, payer type, comorbidities, tobacco use and substance abuse. The study included a matched sample of 8,402 NSS and 8,402 NNSS patients (median age 54 years; 41% female). NSS patients had a significantly greater mean number of psychiatrist visits (7.5 vs 5.5, p<0.001), psychologist visits (5 vs 4, p=0.04), outpatient visits (8.4 vs 5.5, p<0.001), and inpatient admissions (6.8 vs 4.5, p<0.001), and longer inpatient stays (74.6 days vs 66.3 days, p=0.001), compared with NNSS patients over the study period. The estimated mean annual behavioral inpatient cost of care for NSS patients ($45,410, SD=$26,768) was significantly higher than for NNSS patients ($33,049, SD=$16,656) over the study period (p<0.001). Similarly, the estimated mean annual total cost of care for NSS patients ($55,864, SD=$68,298) was significantly higher than for NNSS patients ($43,385, SD=$40,068) over the same period (p<0.001). This study demonstrates increased healthcare utilization and cost burden among NSS patients compared with NNSS patients and underscores the need for innovation in care for these patients.