Marie-Hélène Lafeuille1, Amanda Melina Grittner2, Jonathan Fortier2, Erik Muser2, John Fasteneau2, Mei Sheng Duh2, Patrick Lefebvre2. 1. Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée. mlafeuille@analysisgroup.com. 2. Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
Abstract
PURPOSE: Comparative data on rehospitalization patterns and associated institutional costs after inpatient treatment with paliperidone palmitate or oral antipsychotic therapy are reported. METHODS: A retrospective cohort study was conducted using discharge and billing records from a large hospital database. Selected clinical and cost outcomes were compared in a cohort of adult patients who received the long-acting antipsychotic paliperidone palmitate during a schizophrenia-related index hospital stay and a cohort of patients who received oral antipsychotic therapy during their index admission. Inverse probability-of-treatment weights based on propensity scores were used to reduce confounding. Rates of all-cause and schizophrenia-related rehospitalization and emergency room (ER) use in the two cohorts over periods of up to 12 months were analyzed using a multivariate Cox proportional hazard model. Institutional costs for the evaluated postdischarge events were compared via multivariate linear regression analysis. RESULTS: In the first 12 months after index hospital discharge, the risk of all-cause rehospitalization and ER use was significantly lower in the paliperidone palmitate cohort than in the oral antipsychotic cohort (hazard ratio, 0.61; 95% confidence interval [CI], 0.59-0.63; p < 0.0001); institutional costs during the first 6 months after discharge were significantly lower in the paliperidone palmitate cohort than in the comparator group (adjusted mean monthly cost difference -$404; 95% CI, -$781 to -$148; p < 0.0001). CONCLUSION: The use of paliperidone palmitate therapy during patients' index hospital admission for schizophrenia was associated with a reduced risk of hospital readmission or ER use and lower postdischarge institutional costs.
PURPOSE: Comparative data on rehospitalization patterns and associated institutional costs after inpatient treatment with paliperidone palmitate or oral antipsychotic therapy are reported. METHODS: A retrospective cohort study was conducted using discharge and billing records from a large hospital database. Selected clinical and cost outcomes were compared in a cohort of adult patients who received the long-acting antipsychotic paliperidone palmitate during a schizophrenia-related index hospital stay and a cohort of patients who received oral antipsychotic therapy during their index admission. Inverse probability-of-treatment weights based on propensity scores were used to reduce confounding. Rates of all-cause and schizophrenia-related rehospitalization and emergency room (ER) use in the two cohorts over periods of up to 12 months were analyzed using a multivariate Cox proportional hazard model. Institutional costs for the evaluated postdischarge events were compared via multivariate linear regression analysis. RESULTS: In the first 12 months after index hospital discharge, the risk of all-cause rehospitalization and ER use was significantly lower in the paliperidone palmitate cohort than in the oral antipsychotic cohort (hazard ratio, 0.61; 95% confidence interval [CI], 0.59-0.63; p < 0.0001); institutional costs during the first 6 months after discharge were significantly lower in the paliperidone palmitate cohort than in the comparator group (adjusted mean monthly cost difference -$404; 95% CI, -$781 to -$148; p < 0.0001). CONCLUSION: The use of paliperidone palmitate therapy during patients' index hospital admission for schizophrenia was associated with a reduced risk of hospital readmission or ER use and lower postdischarge institutional costs.
Authors: A Orrico-Sánchez; M López-Lacort; C Muñoz-Quiles; G Sanfélix-Gimeno; J Díez-Domingo Journal: BMC Psychiatry Date: 2020-04-05 Impact factor: 3.630