Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ 08560, USA.
J Med Econ. 2010;13(4):610-7. doi: 10.3111/13696998.2010.525981. Epub 2010 Oct 6.
To compare psychiatric-related healthcare resource utilization (inpatient facility admissions, emergency room visits and ambulatory visits) and costs (medical, pharmacy and total healthcare costs) in patients initiated on paliperidone extended release (ER), risperidone, aripiprazole, olanzapine, ziprasidone or quetiapine.
This exploratory, retrospective administrative claims analysis database compared patients from a large US commercial health plan who were initiated on their index oral atypical antipsychotics between January 1, 2007, and June 30, 2007. Cohorts were assigned by first antipsychotic claim and propensity score-matched by age, gender, US census division, race, household income, baseline antipsychotic use, co-morbid conditions and psychiatric-related utilization. Psychiatric-related healthcare resource utilization and costs were measured for 6 months post-initiation. Descriptive analyses compared paliperidone ER with the other cohorts.
There were 562 patients in matched paliperidone ER (n = 95), risperidone (n = 94), aripiprazole (n = 94), olanzapine (n = 89), ziprasidone (n = 95) or quetiapine (n = 95) cohorts. The paliperidone ER cohort had fewer mean psychiatric-related ambulatory visits than the risperidone cohort (p = 0.05). The paliperidone ER cohort had significantly lower mean psychiatric-related medical costs than the olanzapine, quetiapine and ziprasidone cohorts (p < 0.05) and lower total costs than the ziprasidone and olanzapine cohorts (p = 0.02). No other outcomes were significantly different.
Small sample sizes and short post-index observation times due to the launch of paliperidone ER in January 2007, coupled with the inherent lag time with medical claims data, limit the generalizability of the study findings.
Patients treated with paliperidone ER may have psychiatric-related utilization costs that are comparable to those of patients who initiated treatment with other oral atypical antipsychotics.
比较精神科相关医疗资源利用(住院、急诊和门诊就诊)和成本(医疗、药房和总医疗费用),这些资源和成本在使用帕利哌酮延释片、利培酮、阿立哌唑、奥氮平、齐拉西酮或喹硫平的患者中有所不同。
这项探索性、回顾性的行政索赔分析数据库比较了来自一家大型美国商业健康计划的患者,这些患者在 2007 年 1 月 1 日至 2007 年 6 月 30 日期间首次使用他们的一线口服非典型抗精神病药物。队列根据第一例抗精神病药物索赔和倾向评分进行分组,按年龄、性别、美国人口普查区、种族、家庭收入、基线抗精神病药物使用、合并症和精神科相关利用情况进行匹配。在起始后 6 个月内测量了精神科相关的医疗资源利用和成本。描述性分析比较了帕利哌酮延释片与其他队列。
在匹配的帕利哌酮延释片(n=562)、利培酮(n=95)、阿立哌唑(n=94)、奥氮平(n=89)、齐拉西酮(n=95)或喹硫平(n=95)队列中,有 562 名患者。帕利哌酮延释片队列的平均精神科门诊就诊次数少于利培酮队列(p=0.05)。帕利哌酮延释片队列的精神科相关医疗费用明显低于奥氮平、喹硫平和齐拉西酮队列(p<0.05),总费用也低于齐拉西酮和奥氮平队列(p=0.02)。其他结果无显著差异。
由于帕利哌酮延释片于 2007 年 1 月推出,样本量较小,索引后观察时间较短,再加上医疗索赔数据的固有滞后时间,限制了研究结果的普遍性。
接受帕利哌酮延释片治疗的患者的精神科相关利用成本可能与其他口服非典型抗精神病药物治疗的患者相当。