Davis Rachael C, Xu Jianing, Hall Daniel B, Chen Xianyan, Moretz Michaelyn M, Young Henry N, Caballero Joshua
Pharmacy Student, College of Pharmacy, University of Georgia, Athens, Georgia.
PhD Student, Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia.
Ment Health Clin. 2024 Dec 2;14(6):334-338. doi: 10.9740/mhc.2024.12.334. eCollection 2024 Dec.
Single-dose injectable aripiprazole lauroxil (SDIAL) is used with long-acting injectable (LAI) aripiprazole lauroxil in the treatment of schizophrenia. SDIAL can be used to either initiate treatment or supplement during maintenance when follow-up doses are not given within labeling recommendations. The primary objective was to determine the usage and appropriateness of SDIAL between the initiation and the maintenance supplementation use in a Medicaid database. The secondary objective was to determine the overall associated costs with the potentially inappropriate use of LAI aripiprazole lauroxil.
International Classification of Diseases, 10th edition codes were used to identify adult patients with schizophrenia and related disorders (18-64 years) who received SDIAL and/or LAI aripiprazole lauroxil between 2018 and 2020 using MarketScan Medicaid databases. The appropriateness of SDIAL was determined by package insert labeling timelines for treatment initiation and maintenance supplementation. Two authors independently reviewed each SDIAL claim for appropriateness. Descriptive statistics were used to analyze the data.
After excluding possible billing errors, a total of 582 claims were identified for SDIAL. Of these, 21% were potentially inappropriate, with a higher proportion occurring during the maintenance phase. Overall, potential inappropriate use resulted in costs over $307 000.
It appears that prescribers should be better educated on the appropriate use of SDIAL during maintenance supplementation.
单剂量注射用阿立哌唑月桂醇（SDIAL）与长效注射用阿立哌唑月桂醇联合用于精神分裂症的治疗。当后续剂量未按照标签推荐给药时，SDIAL可用于启动治疗或在维持治疗期间进行补充。主要目的是在医疗补助数据库中确定SDIAL在启动治疗和维持补充使用之间的使用情况及合理性。次要目的是确定长效注射用阿立哌唑月桂醇潜在不当使用所产生的总体相关成本。
使用国际疾病分类第十版编码，通过MarketScan医疗补助数据库识别2018年至2020年间接受SDIAL和/或长效注射用阿立哌唑月桂醇的18至64岁精神分裂症及相关障碍成年患者。SDIAL的合理性根据治疗启动和维持补充的包装说明书标签时间线来确定。两位作者独立审查每份SDIAL索赔的合理性。使用描述性统计分析数据。
排除可能的计费错误后，共识别出582份SDIAL索赔。其中，21%可能存在不当使用，在维持阶段出现的比例更高。总体而言，潜在的不当使用导致成本超过30.7万美元。
看来，在维持补充治疗期间，应更好地教育处方医生正确使用SDIAL。
