Treatment patterns and hospitalizations following rejection, reversal, or payment of the initial once-monthly paliperidone palmitate long-acting injectable antipsychotic claim among patients with schizophrenia or schizoaffective disorder

• Published in: Journal of managed care & specialty pharmacy 2024-09, Vol.30 (9), p.954-966
• Main Authors: Benson, Carmela, Patel, Charmi, Lee, Inyoung, Shaikh, Nazneen Fatima, Wang, Yi, Zhao, Xiaohui, Near, Aimee M.
• Format: Article
• Language: English
• ISSN: 2376-0540; 2376-1032
• DOI: 10.18553/jmcp.2024.23252

Monthly paliperidone palmitate injection (PP1M) is a treatment option for patients with schizophrenia or schizoaffective disorder (SCA). Our study found that the first PP1M prescription was rejected by payers for 31.6% of patients and abandoned by 26.2% of patients. Approximately half of these patients received their PP1M 2-3 weeks later. Compared with patients who received their first PP1M, patients abandoning their first PP1M had a higher risk for schizophrenia/SCA-related hospitalizations later. This study examined treatment patterns and hospitalization related to schizophrenia or SCA following payer rejection, patient reversal, or payment of an initial PP1M claim among patients with schizophrenia or SCA. The results indicate that payer rejection or patient reversal can lead to a delay or failure in receiving PP1M, which can impact patient outcomes. Therefore, policy initiatives that remove barriers to primary adherence or fulfillment may help improve patients’ clinical outcomes.