Real-world outcomes post-transition to once-every-3-months paliperidone palmitate in patients with schizophrenia within US commercial plans

• Published in: Current medical research and opinion 2019-03, Vol.35 (3), p.407-416
• Main Authors: Emond, Bruno, El Khoury, Antoine C., Patel, Charmi, Pilon, Dominic, Morrison, Laura, Zhdanava, Maryia, Lefebvre, Patrick, Tandon, Neeta, Joshi, Kruti
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antipsychotic agents; Antipsychotic Agents - administration & dosage; Delivery of healthcare; Drug Administration Schedule; Female; Healthcare costs; Humans; Male; Medication adherence; Middle Aged; Paliperidone palmitate; Paliperidone Palmitate - administration & dosage; Retrospective Studies; Schizophrenia; Schizophrenia - drug therapy
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1080/03007995.2018.1560220

Objectives: To compare comorbidity-related outcomes, adherence to antipsychotics (APs), healthcare resource utilization (HRU), and costs pre- and post-transition to once-every-3-months paliperidone palmitate (PP3M) in commercially-insured patients with schizophrenia. Methods: Adults with ≥1 claim for PP3M, ≥2 schizophrenia diagnoses, and adequate treatment with once-monthly paliperidone palmitate (PP1M; i.e. no gap of >45 days in PP1M coverage for ≥4 months, same PP1M dosage for the last two PP1M claims, and appropriate PP1M to PP3M dosing conversion) were selected from the IQVIA PharMetrics Plus database (May 2014-February 2018). Generalized estimating equation models adjusted for repeated measurements were used to compare patient characteristics, adherence to APs, HRU, and costs during the 6-month period pre- vs post-transition to PP3M. Results: Of 152 included patients, the mean age was 41.0 years and 36.2% were females. Post-PP3M transition, patients were less likely to have a claim with a diagnosis for substance-related and addictive disorders (odds ratio [OR] = 0.57), psychoses (OR = 0.57), diabetes without chronic complication (OR = 0.72), and drug abuse (OR = 0.64; all p  .05). Conclusions: Transitioning to PP3M was associated with an improvement in adherence and in comorbidity-related outcomes related to substance-related and addictive disorders, psychoses, diabetes without chronic complication, and drug abuse. These findings suggest PP3M may enhance comorbidity-related outcomes and adherence while remaining cost neutral.