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Health resource utilization, costs, and community treatment order status before and after the initiation of second-generation long acting-injectable antipsychotics in patients with schizophrenia in Alberta, Canada

Published online by Cambridge University Press:  01 September 2022

P. Chue ,
K.O. Wong ,
S. Klarenbach ,
K. Martins ,
S. Dursun ,
M. Snaterse  and
L. Richer
P. Chue*
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
K.O. Wong
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
S. Klarenbach
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
K. Martins
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
S. Dursun
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
M. Snaterse
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
L. Richer
Affiliation:
UNIVERSITY OF ALBERTA, Psychiatry, EDMONTON, Canada
*
*Corresponding author.

Abstract

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Introduction

Long-acting injectable (LAI) antipsychotics and community treatment orders (CTOs) are used in patients with schizophrenia to improve treatment effectiveness through adherence.

Objectives

Understanding healthcare resource utilization (HRU) and associated costs, and medication adherence in patients with schizophrenia overall and by CTO status before and after second generation antipsychotic (SGA) LAI initiation may guide strategies to optimize health.

Methods

A retrospective observational single-arm study using administrative data from Alberta was performed. Adults with schizophrenia who initiated SGA-LAI (index date) were included. Medication possession ratio (MPR) was determined; paired t-tests were used to examine differences in HRU and costs ($CDN) between the 2-year pre-index period and 2-year post-index period. Stratified analysis by presence or absence of an active CTO during the pre-post periods was performed.

Results

Among 1,211 patients who initiated SGA-LAIs, MPR was greater post-index (0.84) compared with pre-index (0.45; 95% confidence interval [CI] 0.36, 0.41). All-cause and mental health-related HRU and costs were lower post-index versus pre-index (p<0.001); total all-cause HRU costs were $33,788 lower post- versus pre-index ($40,343 [standard deviation, SD $68,887] versus $74,131 [SD $75,941], 95% CI [-$38,993, -$28,583]), and total mental health-related HRU costs were $34,198 lower post- versus pre-index ($34,205 [SD $63,428] CDN versus $68,403 [SD $72,088] CDN, 95%CI [-$39,098, -$29,297]). Forty-three percent had ≥1 active CTO during the study period; HRU and costs varied according to CTO status.

Conclusions

SGA-LAIs are associated with improved adherence, and lower HRU and costs however the latter vary according to CTO status.

Disclosure

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this abstract: SD and MS have no competing interest to declare. LR, SK, KW, and KM are members of the Real-World Evidence

Keywords

LONG ACTING ANTIPSYCHOTIC INJECTIONHEALTH RESOURCE UTILIZATIONCOMMUNITY TREATMENT ORDERschizophrénia
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S117
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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