PMH9: HEALTH CARE UTILIZATION AND COSTS IN SCHIZOPHRENIC PATIENTS TAKING RISPERIDONE VERSUS OLANZAPINE IN A VETERANS ADMINISTRATION POPULATION

Abstract

OBJECTIVES: To compare the change in health care utilization and costs from one year before (preperiod) and one year after (postperiod) starting treatment with risperidone or olanzapine in schizophrenia patients in a Veterans Administration population. METHODS: Patients with a diagnosis of schizophrenia (ICD-9 CM code 295) in the preperiod, who had an initial prescription for risperidone or olanzapine dispensed between 3/97 and 3/99, were included. Patients who received any atypical antipsychotic in the preperiod were excluded. Comparisons of average change in utilization and cost from the preperiod to the postperiod were made between the groups for: inpatient hospitalizations, outpatient clinic visits, medications, and total health care cost. Analysis of covariance was used to analyze the data using age, gender, and race as covariates. RESULTS: 304 patients in the olanzapine group and 344 in the risperidone group were included. The olanzapine group had significantly more inpatient admissions per patient (0.09 vs. −0.24, p = 0.026), longer inpatient lengths of stay (4.3 days vs. −4.2 days, p = 0.004), and higher cost of inpatient admissions ($2735 vs. −$3226, p = 0.003) than the risperidone group. There was a significantly lower cost of antipsychotic for the risperidone group than for the olanzapine group ($650 vs. $1660, p < 0.001). The mean daily doses were 3.4 mg of risperidone and 12.0 mg of olanzapine. The olanzapine group also had a significantly higher change in cost for all drugs ($1492 vs. $683, p < 0.001) and all health care costs ($5,665 vs. −$1,167, p < 0.001) than the risperidone group. CONCLUSIONS: The changes in total health care costs, number, length of stay, and cost of inpatient admissions, and medication costs for risperidone-treated patients were significantly lower compared with olanzapine-treated patients.