scholarly journals T201. EFFECTS OF PALIPERIDONE PALMITATE ON HEALTHCARE UTILIZATION AND COSTS FOR PATIENTS WITH SCHIZOPHRENIA: A CLAIM-BASED MIRROR-IMAGE STUDY IN SOUTH KOREA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Myung Hun Jung ◽  
Duk-In Jon ◽  
Jung-Seo Yi ◽  
Boung Chul Lee
Keyword(s):  
Healthcare Utilization ◽  
Mirror Image ◽  
Paliperidone Palmitate ◽  
Outpatient Services ◽  
Image Study ◽  
Asian Populations ◽  
Before And After ◽  
Icd 10 ◽  
Prescription Costs ◽  
Long Acting

Abstract Background Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results The results showed that patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p < .0001) and the associated costs increasing by USD 1,497.15 (p < .0001). In contrast, the number of admission days was reduced by 11.33 after starting PP treatment (p < .0001) and the associated costs were reduced by USD 1,220.75 (p < .0001). Discussion Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.

scholarly journals Partial compliance with long-acting paliperidone palmitate and impact on hospitalization: a 6-year mirror-image study

2020 ◽  
Vol 10 ◽  
pp. 204512532092478 ◽  
Author(s):  
Sofia Pappa ◽  
Katy Mason
Keyword(s):  
Hospital Admissions ◽  
Mirror Image ◽  
Poor Compliance ◽  
Paliperidone Palmitate ◽  
Image Study ◽  
Partial Compliance ◽  
Before And After ◽  
The Mean ◽  
Oral Antipsychotic ◽  
Long Acting

Background: Previous studies showed a linear correlation between partial compliance with an oral antipsychotic medication and hospitalisation risk among patients with schizophrenia. Long-acting injections (LAIs) may significantly improve adherence and reduce relapse in patients with psychosis. The aim of this study was to evaluate the relationship between the level of compliance with 1-monthly paliperidone palmitate (PP1M) and hospitalisation rates. Methods: This was a naturalistic, mirror-image study examining retention, compliance and hospitalisation rates 3 years pre- and 3 years post-PP1M initiation. Compliance was divided in three groups: full (no missed dose/year), good (6–11injections/year), poor (<6 injections/year). Results: A total of 173 patients suffering from a severe mental illness (70% with a diagnosis of schizophrenia and 30% with other diagnoses) were included; 77% of patients continued PP1M for 1 year, 66% for 2 years and 55% for 3 years. Of the 95 patients who remained on PP1 throughout the 3 years of follow up, 81% showed full, 13% good, and only 6% poor compliance. In the patients who were fully compliant, the mean number of hospital admissions decreased from 1.34 to 0.43, and the mean number of bed days from 82 to 19 days per patient 3 years before and 3 years after PP1M initiation ( p < 0.001). It is noteworthy that the reductions in hospital stay were statistically significant for the group of patients with full compliance but not for the other two groups. In fact, patients with poor compliance demonstrated higher hospitalisation rates both before and after PPM1 initiation. These findings were similar in the subgroup of patients with schizophrenia who continued treatment for 3 years ( n = 68). Conclusion: There was a direct association between partial compliance and re-hospitalisation; fully compliant patients maintained the best outcomes in terms of reduced bed use following PPM1 initiation.

Switching to paliperidone palmitate in an outpatient sample: Preliminary results of a 43-month follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. S368-S369
Author(s):  
R. Martín Gutierrez ◽  
R. Medina Blanco ◽  
D. Sierra Biddle ◽  
M.J. Cuesta Nuñez ◽  
P. Suárez Pinilla
Keyword(s):  
Psychotic Disorders ◽  
Mirror Image ◽  
Paliperidone Palmitate ◽  
Health Clinic ◽  
Image Study ◽  
Emergency Visits ◽  
Outpatient Mental Health ◽  
Before And After ◽  
Long Acting ◽  
Bipolar Patients

IntroductionPatients with psychosis are treated in outpatient community clinics during most of their lifetime. Antipsychotic treatments are commonly used in regular clinical practice. However, the non-adherence is one of the main causes of relapses. Long-acting injectables (LAIs) could be a safe option to guarantee the efficacy.Aim and objectivesOur purpose is to evaluate the efficacy of the switch to paliperidone palmitate from other oral or LAI antipsychotics, in terms of hospital and emergency admissions.MethodsWe performed a mirror-image study in an outpatient mental health clinic, comparing patients before and after paliperidone palmitate change over 43 months. Fifty-seven patients were included, most of them (n = 47) were diagnosed with psychotic disorders (82.5%) while 4 were bipolar patients (7%), and the remained patients (n = 6; 10.6%) were classified as behavioral disorders. The following variables were studied before and after the switching: number of admissions, days of stay and emergency visits.ResultsFrom those 57 patients, 44 were previously treated with other LAIs, whereas 13 were taking oral antipsychotics. The median age at switch was 49 years (SD = 12.31). The reasons for switching were: inefficacy (26.3%), non-adherence (19.3%), side effects (38.6%), and non-specified (15.8%). We found significant differences between the three main variables: number of admissions (t = 4.59; P ≤ 0.001), days of stay (t = 2.27; P = 0.027) and emergency visits (t = 3.74; P ≤ 0.001).ConclusionsPaliperidone palmitate seems to be an effective treatment in order to guarantee the adherence. Our preliminary data show that paliperidone palmitate might reduce the sanitary cost in outpatients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Effectiveness of 2-year treatment with aripiprazole long-acting injectable and comparison with paliperidone palmitate

2021 ◽  
Vol 11 ◽  
pp. 204512532110294
Author(s):  
Katy Mason ◽  
Joshua Barnett ◽  
Sofia Pappa
Keyword(s):  
Psychotic Disorders ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Mirror Image ◽  
Retention Rates ◽  
Paliperidone Palmitate ◽  
Image Study ◽  
Substantial Impact ◽  
The Mean ◽  
Long Acting

Background: The pragmatic management of psychotic disorders is more complex than that delivered in a controlled trial environment. Therefore, this study aims to evaluate the real-world effectiveness of aripiprazole long-acting injectable (ALAI) and compare it with another commonly used long-acting anti-psychotic, once-monthly paliperidone palmitate (PP1M). Methods: This naturalistic, independent 4-year mirror image study compared the mean number and length of hospital admissions 2 years before and 2 years after treatment initiation with ALAI. Retention rates, discontinuation reasons and level of adherence were also recorded. Furthermore, indirect comparisons were made between treatment outcomes on ALAI and PP1M. Results: A total of 109 eligible patients with a severe mental illness (65% with schizophrenia and 35% with other diagnosis) commenced on ALAI and 173 patients (69% with schizophrenia and 31% with other diagnoses) initiated on PP1M were included. Of these, 37% on ALAI and 34% on PP1M stopped treatment at 2 years; retention rates were most favourable for the schizophrenia group on PP1M. Patients were more likely to discontinue due to lack of effectiveness on ALAI and due to tolerability issues on PP1M. Those who continued for 2 years on ALAI ( n = 69), demonstrated an overall decrease of 84% in the mean number and 88% in the mean length of hospital admissions compared with the 2 years before initiation. Although patients on ALAI appeared to have a significantly higher bed occupancy the 2-year period before initiation than patients on PP1M, the reductions in hospitalizations were comparable across both cohorts after 2 years of treatment. Conclusions: The introduction of ALAI had a substantial impact on long-term clinical outcomes in this naturalistic cohort; more than half of patients continued treatment and had no admission during 2 years of follow up. There were no significant differences in hospitalisation rates between patients on ALAI and PP1M at 2 years.

scholarly journals Clozapine and paliperidone palmitate antipsychotic combination in treatment-resistant schizophrenia and other psychotic disorders: A retrospective 6-month mirror-image study

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Miquel Bioque ◽  
Eduard Parellada ◽  
Clemente García-Rizo ◽  
Sílvia Amoretti ◽  
Adriana Fortea ◽  
...  
Keyword(s):  
Side Effects ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Symptom Control ◽  
Combined Treatment ◽  
Mirror Image ◽  
Paliperidone Palmitate ◽  
Treatment Resistant ◽  
Image Study ◽  
Long Acting

Abstract Background: Around 30% of patients with schizophrenia are considered treatment resistant (TRS). Only around 40% of TRS patients respond to clozapine. Long acting injectable antipsychotics could be a useful augmentation strategy for nonresponders. Methods: We conducted a multicenter, observational, naturalistic, retrospective, 6-month mirror-image study to evaluate the efficacy and tolerability of clozapine and paliperidone palmitate association in 50 patients with TRS and other psychotic disorders. Clinical outcomes and side effects were systematically assessed. Results: Six months after starting the combined treatment, participants showed a significant relief of symptoms, decreasing the Brief Psychiatric Rating Scale total score from 18.32 ± 7.71 to 7.84 ± 5.16 (p < 0.001). The number of hospitalizations, the length of hospital stays and the number of visits to emergency services also decreased, while an increase of the functionality was observed (Personal and Social Performance total score increased from 46.06 ± 118.7 to 60.86 ± 18.68, p < 0.001). There was also a significant decrease in the number and severity of side effects with the combination therapy, decreasing the Udvalg for Kliniske Undersogelser total score from 10.76 ± 8.04 to 8.82 ± 6.63 (p = 0.004). Conclusions: This study provides the first evidence that combining clozapine with paliperidone palmitate in patients with TRS and other psychotic disorders could be effective and safe, suggesting further research with randomized controlled trials of augmentation strategies for clozapine nonresponder patients. Policy Significance Statement: Patients with psychotic disorders such as schizophrenia show a variable response to antipsychotic treatments. Around 30% of patients are considered treatment resistant, indicated by insufficient symptom control to at least two different drugs. In these resistant cases, clozapine should be indicated, as it has shown to be superior to other options. However, only 40% of patients respond to clozapine, being necessary to establish which treatments could best potentiate clozapine action. Combining clozapine with long acting injectable antipsychotics, and particularly paliperidone palmitate, could be a useful strategy. We conducted a multicenter study of 50 patients with treatment-resistant schizophrenia and other psychotic disorders comparing the efficacy and tolerability in the 6 month-period prior and after starting the clozapine and paliperidone palmitate association. Our study suggests that this combination could be effective and safer, laying the groundwork for future clinical trials with this combination.

scholarly journals Hospitalisation Utilisation and Costs in Schizophrenia Patients in Finland before and after Initiation of Risperidone Long-Acting Injection

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Christian Asseburg ◽  
Michael Willis ◽  
Mickael Löthgren ◽  
Niko Seppälä ◽  
Mika Hakala ◽  
...  
Keyword(s):  
Resource Use ◽  
Mirror Image ◽  
Base Case ◽  
Economic Modelling ◽  
Image Study ◽  
Start Date ◽  
Before And After ◽  
Bed Days ◽  
Long Acting ◽  
The Impact

Objectives. Quantify changes in hospital resource use in Finland following initiation of risperidone long-acting injection (RLAI).Materials and Methods. A retrospective multi-center chart review (naturalistic setting) was used to compare annual hospital bed-days and hospital episodes for 177 schizophrenia patients (mean age 47.1 years, 52% female, 72% hospitalized) before and after initiation of RLAI (between January 2004 and June 2005) using the within-patient “mirror-image” study design. The base case analytical approach allocated hospital episodes overlapping the start date entirely to the preinitiation period. In order to investigate the impact of inpatient care ongoing at baseline, the change in bed-days was also estimated using an alternative analytical approached related to economic modelling.Results. In the conventional analysis, the mean annual hospitalisation costs declined by €11,900 and the number of bed-days was reduced by 40%, corresponding to 0.19 fewer hospital episodes per year. The reductions in bed-days per patient-year were similar for patients switched to RLAI as inpatients and as outpatients. In the modelling-based analysis, an 8% reduction in bed-days per year was observed.Conclusion. Despite uncertainty in the choice of analytic approach for allocating inpatient episodes that overlapping this initiation, consistent reductions in resource use are associated with the initiation of RLAI in Finland.

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