Impact of atypical antipsychotics on outcomes of care in schizophrenia.

OBJECTIVE

To compare persistence, compliance, and psychiatric treatment costs in patients who were initiated on atypical antipsychotics.

METHODS

Medical and pharmacy claims data were used to compare persistence (days of therapy between first and last prescriptions, allowing therapy gaps < 90 days); compliance (ratio of days of medication supplied to total days on therapy); treatment costs in adults with schizophrenia having claims for atypical antipsychotics from March 2001 to August 2003; and enrollment for > or =6 months before and > or =12 months after therapy initiation. Psychiatric treatment costs for 1 year were examined before and after therapy initiation. Differences in costs were tested by univariate analyses.

RESULTS

Persistence was approximately 30 days longer for patients receiving ziprasidone (n = 217; 228 days) than risperidone (n = 831; 193 days) or olanzapine (n = 762; 201 days). Compliance was significantly (P<.05) higher among patients receiving ziprasidone (87%) compared with other treatments (78%-80%). Ziprasidone patients had significantly larger decreases (- USD 6866) in mean annual psychiatric-related costs following therapy initiation than those on risperidone (- USD 3353; P = .0116) or olanzapine (- USD 4764; P = .0021). The primary driver of cost savings was reduced hospitalization after treatment initiation.

CONCLUSION

Patients initiated on ziprasidone had longer persistence, better compliance, and greater decreases in psychiatric-related costs than those initiated on other atypicals.