Healthcare utilization and costs of veterans health administration patients with schizophrenia treated with paliperidone palmitate long-acting injection or oral atypical antipsychotics

Figures & data

Table 1. Baseline characteristics for study qualified and propensity score matched cohorts.

	Study qualified cohorts					Matched cohorts
	PP (n = 381)		OAT (n = 3537)			PP (n = 335)		OAT (n = 335)
24-month baseline period	n/Mean	%/SD	n/Mean	%/SD	p Value	n/Mean	%/SD	n/Mean	%/SD	p Value
Age, years	50.16	10.54	52.17	9.14	<0.001	51.25	9.85	51.20	10.32	0.945
Gender
Female	31	8%	266	8%	0.666	24	7%	29	9%	0.474
Male	350	92%	3271	92%	0.666	311	93%	306	91%	0.474
Psychiatric medication
Number of unique antipsychotic medications	2.66	1.30	1.71	1.02	<0.001	2.56	1.23	2.56	1.27	0.975
Baseline comorbidity
Charlson Comorbidity Index	1.21	1.21	1.34	1.31	0.058	1.25	1.25	1.29	1.20	0.659
Other mental health diagnoses	240	63%	2389	68%	0.072	211	63%	233	70%	0.072
Diabetes	95	24.93	895	25.30	0.875	87	26%	89	27%	0.861
Alcohol abuse	88	23%	863	24%	0.573	78	23%	89	27%	0.326
Obesity	139	36%	945	27%	<0.001	112	33%	108	32%	0.742
All-cause healthcare utilization
Any hospitalization	242	64%	1830	52%	<0.001	209	62%	216	64%	0.574
Number of hospitalizations per patient	2.14	3.32	1.55	2.71	0.001	2.08	3.33	2.17	3.00	0.724
Number of inpatient days per patient	30.07	53.70	38.17	100.77	0.012	30.69	56.17	44.13	118.45	0.061
Any ER visit	44	12%	757	21%	<0.001	43	13%	49	15%	0.501
Number of ER visits per patient	0.27	0.96	0.61	2.26	<0.001	0.30	1.01	0.57	2.88	0.108
Baseline all-cause healthcare costs per patient
Inpatient costs	$39,081	$57,566	$32,432	$77,978	0.040	$39,601	$59,805	$39,822	$80,791	0.968
Pharmacy costs	$10,601	$13,991	$4079	$5895	<0.001	$10,281	$14,320	$6401	$7533	<0.001
ER costs	$54	$268	$261	$1031	<0.001	$60	$284	$214	$1125	0.015
Outpatient office visit costs	$35,742	$32,440	$22,915	$26,719	<0.001	$33,879	$31,111	$34,483	$33,067	0.808
Other outpatient costs	$422	$1556	$341	$2787	0.377	$435	$1639	$195	$527	0.011
Total costs (Outpatient + Inpatient + Pharmacy)	$85,900	$73,363	$60,028	$86,699	<0.001	$84,257	$75,611	$81,116	$91,145	0.628

SD, standard deviation. All-cause healthcare utilization was calculated by the number of claims (e.g. hospitalizations, ER visits) in the health record and the proportion of the study population that had a claim. Costs from the health record were adjusted to 2012 US dollars using the medical care component of the Consumer Price Index (CPI).

Figure 1. Propensity score distributions of the study qualified population cohorts and the matched cohorts. (a) Study qualified cohorts. (b) Matched cohorts. PP, paliperidone palmitate long-acting injection; OAT, atypical oral antipsychotic therapy.

Table 2. Utilization and cost outcomes for the matched PP and OAT cohorts (12-month follow-up period).

	PP cohort (n = 335)			OAT cohort (n = 335)
12-month follow-up period	n/Mean	%/SD	Median	n/Mean	%/SD	Median	p Value
Post-index all-cause healthcare utilization
Any hospitalization	113	34%		176	53%		<0.001
Number of hospitalizations per patient	0.81	1.60		1.30	1.87		<0.001
Number of inpatient days per patient	13.24	36.19		24.18	52.05		0.002
Any ER visit	23	7%		33	10%		0.163
Number of ER visits per patient	0.12	0.55		0.28	1.29		0.033
Any outpatient office visit	335	100%		327	98%		0.004
Number of outpatient office visits per patient	46.68	38.12		42.71	39.88		0.189
Post-index all-cause healthcare costs per patient
Inpatient costs	$18,560	$46,761	$0	$31,505	$60,713	$7771	0.002
Pharmacy costs	$10,063	$18,977	$6889	$4167	$4446	$2845	<0.001
ER costs	$20	$112	$0	$64	$312	$0	0.015
Outpatient office costs	$16,723	$15,809	$11,349	$16,556	$20,915	$10,839	0.908
Other outpatient costs	$163	$534	$0	$276	$1125	$0	0.099
Total costs (outpatient + inpatient + pharmacy)	$45,529	$54,696	$28,982	$52,569	$64,391	$30,836	0.128

SD, standard deviation. All-cause healthcare utilization was calculated by the number of claims (e.g. hospitalizations, ER visits, outpatient visits) in the health record and the proportion of the study population that had a claim. Costs from the health record were adjusted to 2012 US dollars using the medical care component of the Consumer Price Index (CPI).

Figure 2. Healthcare costs for the matched PP and OAT cohorts. * p < 0.05. PP, paliperidone palmitate long-acting injection; OAT, atypical oral antipsychotic therapy; ER, emergency room.

Figure 3. Healthcare utilization for the matched PP and OAT cohorts. PP, paliperidone palmitate long-acting injection; OAT, atypical oral antipsychotic therapy; ER, emergency room.