Exploratory analysis of psychiatric-related utilization and costs associated with paliperidone ER compared with other oral atypical antipsychotics using pharmacy claims from an administrative database

Abstract

Objective:

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.

Methods:

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.

Results:

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.

Limitations:

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.

Conclusion:

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.

Key words:

• atypical antipsychotics
• paliperidone ER
• resource utilization

Transparency

Declaration of funding

This analysis was supported by funding from Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ, USA.

Declaration of financial/other relationships

R.H. and F.C. have disclosed that they were contracted by Johnson & Johnson Pharmaceutical Services, LLC, to access and analyze the data. J.M.P. and R.D. have disclosed that they are employees of Ortho-McNeil Janssen Scientific Affairs, LLC, and that they are Johnson & Johnson stockholders.

Acknowledgments

The authors acknowledge the writing and editing assistance provided by Matthew Grzywacz, PhD, Mariana Ovnic, PhD and ApotheCom in the development and submission of this manuscript.