Impact on healthcare resource usage and costs among Medicaid-insured schizophrenia patients after initiation of treatment with long-acting injectable antipsychotics

Figures & data

Table 1.  Baseline demographics of the Medicaid study population.

Demographic	n	%
Age group (years)
≤17	106	1.86%
18–35	2247	39.46%
36–45	1296	22.76%
46–55	1354	23.78%
56–65	578	10.15%
66–75	77	1.35%
≥76	36	0.63%
Gender
Male	3111	54.64%
Female	2583	45.36%
Race
White	2125	37.32%
Black	3025	53.13%
Hispanic	74	1.30%
Other	470	8.25%
Health plan type
Comprehensive	3803	66.79%
HMO	485	8.52%
POS w/capitation	1402	24.62%
Others/unknown	4	0.07%
Index drug
Fluphenazine	824	14.47%
Haloperidol	2341	41.11%
Risperidone	2529	44.42%
Total patient count	5694

HMO, Health Maintenance Organization; POS, Point-of-Service.

Table 2.  Baseline clinical characteristics of the Medicaid study population.

Clinical characteristic	n	%
CCI group
0	3816	67.02
1–2	1498	26.31
3–4	260	4.57
≥5	120	2.11
Comorbid condition
Diabetes	959	16.84
Chronic pulmonary disease	777	13.65
Congestive heart failure	127	2.23
Cerebrovascular disease	127	2.23
Liver disease	124	2.18
Peripheral vascular disease	113	1.98
Dementia	107	1.88
Renal disease	77	1.35
Peptic ulcer disease	69	1.21
Cancer	68	1.19
Myocardial infarction	36	0.63
Rheumatic disease	35	0.61
Baseline oral antipsychotic medication
Risperidone	2541	44.63
Quetiapine	1448	25.43
Haloperidol	1208	21.22
Olanzapine	836	14.68
Aripiprazole	717	12.59
Fluphenazine	330	5.80
Clozapine	203	3.57
Paliperidone	188	3.30
Perphenazine	77	1.35
Baseline other medication
Antidepressants	2654	46.61
Anticonvulsants	2642	46.40
Analgesics/Antipyretics	1776	31.19
Anxiolytics/Sedatives/Hypnotics	943	16.56
Antimanic	412	7.24

CCI, Deyo-Charlson Comorbidity Index.

Table 3.  Healthcare resource usage and costs, any cause, and schizophrenia-related for the Medicaid study population before and after initiation of LAI antipsychotics.

Healthcare resource/Cost per year (mean ± SD)	Before	After	Difference	p-value
Any cause inpatient usage
Number of hospitalizations	1.52 ± 2.41	0.70 ± 1.61	−0.82	<0.001
Total length of stay (days)	14.77 ± 28.61	5.75 ± 16.26	−9.02	<0.001
Total payment	$16,249 ± $36,404	$7380 ± $21,087	−$8869	<0.001
Schizophrenia-related inpatient usage
Number of hospitalizations	1.21 ± 2.04	0.57 ± 1.41	−0.64	<0.001
Total length of stay (days)	12.39 ± 25.86	4.67 ± 13.54	−7.72	<0.001
Total payment	$13,388 ± $31,614	$5645 ± $15,767	−$7744	<0.001
Any cause outpatient claims
Total number of outpatient claims	105.99 ± 111.95	105.36 ± 102.33	−0.63	0.754
Total outpatient payment	$7953 ± $12,350	$8157 ± $12,308	$203	0.379
Office visit claims	19.61 ± 38.27	20.63 ± 36.33	1.02	0.146
Total payment	$1387 ± $3446	$1463 ± $3889	$76	0.272
ER claims	14.09 ± 31.74	9.35 ± 25.43	−4.74	<0.001
Total payment	$713 ± $2,084	$498 ± $1642	−$215	<0.001
CMHC claims	19.54 ± 47.83	23.02 ± 48.01	3.48	<0.001
Total payment	$1,399 ± $3492	$1563 ± $3515	$164	0.013
Outpatient pharmacy claims	44.89 ± 49.71	51.11 ± 45.11	6.22	<0.001
Total payment	$4571 ± $5371	$6336 ± $5906	$1765	<0.001
Schizophrenia-related outpatient claims
Total number of outpatient claims	44.88 ± 67.13	49.68 ± 66.28	4.80	<0.001
Total outpatient payment	$3461 ± $6239	$3869 ± $6425	$408	<0.001
Office visit claims	8.11 ± 27.99	9.71 ± 28.57	1.60	0.003
Total payment	$690 ± $2466	$805 ± $2802	$115	0.020
ER claims	3.48 ± 10.99	2.16 ± 7.31	−1.32	<0.001
Total payment	$184 ± $672	$125 ± $526	−$59	<0.001
CMHC claims	15.22 ± 43.83	19.16 ± 44.68	3.94	<0.001
Total payment	$1072 ± $3174	$1296 ± $3292	$224	<0.001
Outpatient pharmacy claims	8.97 ± 10.22	13.57 ± 10.46	4.60	<0.001
Total payment	$2564 ± $3443	$4324 ± $4543	$1760	<0.001

ER, Emergency Room; CMHC, Community Mental Health Center.

Figure 1.  Differences in total, inpatient, outpatient, and pharmacy payments, any cause and schizophrenia-related for the Medicaid study population before and after initiation of LAI antipsychotics.