PMH72 The Impact of Once-Daily Extended-Release Quetiapine Fumarate (Quetiapine XR) on Length of Hospitalisation of Patients with Acute Bipolar Mania

Abstract

THE IMPACT OF ONCE-DAILY EXTENDED-RELEASE QUETIAPINE FUMARATE (QUETIAPINE XR) ON LENGTH OF HOSPITALISATION OF PATIENTS WITH ACUTE BIPOLAR MANIA Bonafede M1, Locklear JC2, Wahlqvist P3, Fajutrao L4, Szamosi J4, Pan K5, Eriksson H4 1Thomson Reuters, Andover, MA, USA, 2AstraZeneca Pharmaceuticals LP, Wilmington, DE, USA, 3AstraZeneca, Molndal, Sweden, 4AstraZeneca, Sodertalje, Sweden, 5Thomson Reuters, Cambridge, MA, USA OBJECTIVES: Rapid titration schedule of extended-release quetiapine fumarate (quetiapine XR) for acute bipolar mania means an effective dose can be reached by Day 2 (versus Day 5 with quetiapine immediate release [IR]). This study evaluates the impact of quetiapine XR on length of hospitalisation in patients with acute bipolar mania, compared with quetiapine IR, using Thomson Reuters MarketScan® Hospital Drug Database data. METHODS: Inpatient discharges with an ICD-9 diagnosis of acute bipolar mania (296.0x, 296.1x, 296.4x or 296.6x), receiving quetiapine XR or IR, were identified. The impact of the XR formulation on length of hospitalisation was assessed using a generalised linear model, adjusting for patient and hospital characteristics. Length of hospitalisation data were not normally distributed, therefore log-transformed data were included. A post hoc sensitivity analysis evaluated length of hospitalisation (excluding an outlier quetiapine XR patient, with a length of stay 3x higher than the second longest). RESULTS: In total, 3088 discharges between July 1, 2007 and August 31, 2010 were analysed. Modelled results showed that treatment with quetiapine XR reduced the length of hospitalisation by 6.7% compared with IR (p50.11), which corresponds to 0.6 fewer days in hospital (6.7% of 9.6 days), based on least squares mean estimations of length of hospitalisation in patients treated with quetiapine IR. With the outlier excluded, quetiapine XR significantly reduced the length of hospitalisation by 9.6% compared with IR (p50.02), corresponding to 0.9 days (9.6% of 9.6 days). CONCLUSIONS: Inpatient use of quetiapine XR in patients with acute bipolar mania may be associated with reduced length of hospitalisation, possibly due to the faster titration schedule for quetiapine XR versus IR. Given the high costs associated with hospitalisation, a reduction in length of stay of approximately 7 to 10% could represent a non-trivial cost reduction and potential savings.