Cutler Andrew J, Panchmatia Hemangi R, Hughes Alejandro G, Webb Noah S, Doane Michael J, Jain Rakesh
SUNY Upstate Medical University, Syracuse, NY, USA.
Alkermes, Inc., 900 Winter Street, Waltham, MA, 02451, USA.
Adv Ther. 2025 Jun 4. doi: 10.1007/s12325-025-03211-w.
A combination of olanzapine and samidorphan (OLZ/SAM), approved by the US Food and Drug Administration (2021) for the treatment of adults with schizophrenia (SZ) or bipolar I disorder (BD-I), mitigates weight gain associated with olanzapine treatment. This study examined changes in healthcare resource utilization (HCRU) among patients with SZ or BD-I after initiating OLZ/SAM.
This retrospective analysis utilized USA-based administrative claims data from April 19, 2021 to December 31, 2022. Adults aged ≥ 18 years with SZ or BD-I who had continuous enrollment ≥ 6 months before (baseline) and after (follow-up) OLZ/SAM initiation (index) were eligible. HCRU comparisons included inpatient admissions, average number of inpatient days, emergency department (ED) visits, and outpatient visits between 6-month baseline and follow-up periods.
In total, 1546 patients initiated OLZ/SAM (SZ: n = 855, mean age 39.4 years, 52.6% male; BD-I: n = 691, 38.4 years, 31.0% male). Overall, 446 (52.2%) patients with SZ and 302 (43.7%) patients with BD-I remained on OLZ/SAM during the full 6-month follow-up (median days persistent 182 and 106, respectively). In the SZ and BD-I cohorts, proportions of patients with all-cause and mental health (MH)-related inpatient admissions and ED visits significantly decreased between baseline and follow-up (all-cause: all P ≤ 0.026; MH-related: all P < 0.001). Findings were similar for disease-specific outcomes with the exception that reductions in BD-I-related ED visits were not significant. Average number of inpatient days decreased after OLZ/SAM initiation in both cohorts; in patients with BD-I, those reductions were statistically significant (all P ≤ 0.022). The proportions of patients with outpatient visits were similar between baseline and follow-up for both cohorts.
Results from this first real-world study assessing HCRU after OLZ/SAM initiation suggest that OLZ/SAM results in reductions in burden for patients, providers, and the healthcare system, as evidenced by reductions in acute all-cause, MH-related, and disease-specific HCRU among SZ and BD-I cohorts.
奥氮平与赛美多芬（OLZ/SAM）联合用药已获美国食品药品监督管理局批准（2021年）用于治疗成人精神分裂症（SZ）或双相I型障碍（BD-I），可减轻与奥氮平治疗相关的体重增加。本研究调查了开始使用OLZ/SAM后，SZ或BD-I患者的医疗资源利用（HCRU）变化。
本回顾性分析利用了2021年4月19日至2022年12月31日美国的行政索赔数据。年龄≥18岁、在开始使用OLZ/SAM（索引）之前（基线）和之后（随访）连续登记≥6个月且患有SZ或BD-I的成年人均符合条件。HCRU比较包括6个月基线期和随访期之间的住院入院次数、平均住院天数、急诊科（ED）就诊次数和门诊就诊次数。
共有1546名患者开始使用OLZ/SAM（SZ：n = 855，平均年龄39.4岁，52.6%为男性；BD-I：n = 691，38.4岁，31.0%为男性）。总体而言，在整个6个月随访期间，446名（52.2%）SZ患者和302名（43.7%）BD-I患者继续使用OLZ/SAM（持续时间中位数分别为182天和106天）。在SZ和BD-I队列中，基线期和随访期之间，全因和心理健康（MH）相关的住院入院和ED就诊患者比例显著下降（全因：所有P≤0.026；MH相关：所有P<0.001）。特定疾病结局的结果相似，但BD-I相关的ED就诊次数减少不显著。两个队列在开始使用OLZ/SAM后平均住院天数均减少；在BD-I患者中，这些减少具有统计学意义（所有P≤0.022）。两个队列基线期和随访期之间门诊就诊患者比例相似。
这项评估开始使用OLZ/SAM后HCRU的首次真实世界研究结果表明，OLZ/SAM可减轻患者、医疗服务提供者和医疗系统的负担，SZ和BD-I队列中急性全因、MH相关和特定疾病的HCRU减少证明了这一点。
