Some current trends in the use of prolonged injectable antipsychotics in the conditions of modernization of the psychiatric service

Abstract

A pharmacoeconomical analysis of the use of prolonged injectable antipsychotics in the treatment of patients with schizophrenia in Moscow over 2015-2019 in the context of the reform of the psychiatric service. The authors studied the economic costs of treatment of psychiatric patients with prolonged injectable antipsychotics on the pharmaceutical market in Moscow for five years on the example of patients diagnosed with paranoid schizophrenia (ICD-10 F20.0) based on the dynamics of the registered contingent of patients with schizophrenic spectrum disorders over the past fifteen years including the period of active modernization of the psychiatric service. A constant increase in public spending on treatment, including therapy with prolonged injectable neuroleptics (both first-generation drugs and atypical antipsychotics), was shown. At the same time, the increase in the use of atypical antipsychotics is ahead of schedule. The number of patients receiving treatment with prolonged injectable haloperidol and zupentixol increased approximately twice during this period, the number of patients receiving treatment with injectable risperidone and paliperidone palmitate increased by more than 3 and 13 times, respectively. There is a significant increase in public spending on the purchase and use of these drugs for the treatment of privileged categories of patients, most of this applies to injectable forms of paliperidone, the cost of using these drugs has increased more than 20 times over a five-year period. These trends indicate a shift in emphasis towards outpatient psychiatric care and improvement of approaches to treatment of patients with schizophrenia, which indicate a new stage in the development of out-of-hospital treatment and rehabilitation systems based on the latest achievements of psychopharmacology and the development of social support systems for patients with schizophrenia spectrum disorders.