Antipsychotic utilization, healthcare resource use and costs, and quality of care among fee-for-service Medicare beneficiaries with schizophrenia in the United States

References

• National Institute of Mental Health. Schizophrenia. National Institute of Mental Health (NIMH). [cited 2023 Jan 26]. n.d. https://www.nimh.nih.gov/health/statistics/schizophrenia.
   Google Scholar
• De Berardis D, De Filippis S, Masi G, et al. A neurodevelopment approach for a transitional model of early onset schizophrenia. Brain Sci. 2021;11:275.
   PubMed Web of Science ®Google Scholar
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5^TM. 5th ed. Arlington (VA): American Psychiatric Publishing, Inc.; 2013.
   Google Scholar
• Regier D, Narrow W, Rae D, et al. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993;50(2):85–94.
   PubMed Web of Science ®Google Scholar
• McGrath J, Saha S, Chant D, et al. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67–76.
   PubMed Web of Science ®Google Scholar
• Desai PR, Lawson KA, Barner JC, et al. Estimating the direct and indirect costs for community-dwelling patients with schizophrenia. J Pharm Health Serv Res. 2013;4:187–194.
   Google Scholar
• Olfson M, Gerhard T, Huang C, et al. Premature mortality among adults with schizophrenia in the United States. JAMA Psychiatry. 2015;72(12):1172–1181.
   PubMed Web of Science ®Google Scholar
• Schoenbaum M, Sutherland JM, Chappel A, et al. Twelve-month health care use and mortality in commercially insured young people with incident psychosis in the United States. Schizophr Bull. 2017;43(6):1262–1272.
   PubMed Web of Science ®Google Scholar
• Simon GE, Stewart C, Yarborough BJ, et al. Mortality rates after the first diagnosis of psychotic disorder in adolescents and young adults. JAMA Psychiatry. 2018;75(3):254–260.
   PubMed Web of Science ®Google Scholar
• Kadakia A, Catillon M, Fan Q, et al. The economic burden of schizophrenia in the United States. J Clin Psychiatry. 2022;83:22m14458.
   PubMed Web of Science ®Google Scholar
• Byerly MJ, Nakonezny PA, Lescouflair E. Antipsychotic medication adherence in schizophrenia. Psychiatr Clin North Am. 2007;30:437–452.
   PubMed Web of Science ®Google Scholar
• Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353(12):1209–1223.
   PubMed Web of Science ®Google Scholar
• Higashi K, Medic G, Littlewood KJ, et al. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Ther Adv Psychopharmacol. 2013;3(4):200–218.
   PubMedGoogle Scholar
• Olivares JM, Sermon J, Hemels M, et al. Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review. Ann Gen Psychiatry. 2013;12:32.
   PubMed Web of Science ®Google Scholar
• Gilmer TP, Dolder CR, Lacro JP, et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004;161(4):692–699.
   PubMed Web of Science ®Google Scholar
• Ascher-Svanum H, Faries DE, Zhu B, et al. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry. 2006;67(3):453–460.
   PubMed Web of Science ®Google Scholar
• Correll CU, Citrome L, Haddad PM, et al. The use of long-acting injectable antipsychotics in schizophrenia: evaluating the evidence. J Clin Psychiatry. 2016;77(suppl 3):1–24.
   PubMed Web of Science ®Google Scholar
• Velligan DI, Weiden PJ, Sajatovic M, et al. Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines. J Psychiatr Pract. 2010;16(5):306–324.
   PubMed Web of Science ®Google Scholar
• West JC, Marcus SC, Wilk J, et al. Use of depot antipsychotic medications for medication nonadherence in schizophrenia. Schizophr Bull. 2008;34(5):995–1001.
   PubMed Web of Science ®Google Scholar
• Yeo V, Dowsey M, Alguera-Lara V, et al. Antipsychotic choice: understanding shared decision-making among doctors and patients. J Ment Health. 2021;30(1):66–73.
   PubMed Web of Science ®Google Scholar
• Marcus SC, Zummo J, Pettit AR, et al. Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. J Manag Care Spec Pharm. 2015;21(9):754–768.
   PubMed Web of Science ®Google Scholar
• Lafeuille M-H, Grittner AM, Fortier J, et al. Comparison of rehospitalization rates and associated costs among patients with schizophrenia receiving paliperidone palmitate or oral antipsychotics. Am J Health Syst Pharm. 2015;72(5):378–389.
   PubMed Web of Science ®Google Scholar
• Pilon D, Tandon N, Lafeuille M, et al. Treatment patterns, health care resource utilization, and spending in medicaid beneficiaries initiating second-generation long-acting injectable agents versus oral atypical antipsychotics. Clin Ther. 2017;39(10):1972–1985.e2.
   PubMed Web of Science ®Google Scholar
• Taipale H, Mehtälä J, Tanskanen A, et al. Comparative effectiveness of antipsychotic drugs for rehospitalization in Schizophrenia-a nationwide study with 20-year follow-up. Schizophr Bull. 2018;44(6):1381–1387.
   PubMed Web of Science ®Google Scholar
• Taipale H, Mittendorfer-Rutz E, Alexanderson K, et al. Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia. Schizophr Res. 2018;197:274–280.
   PubMed Web of Science ®Google Scholar
• Tiihonen J, Haukka J, Taylor M, et al. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011;168:603–609.
   PubMed Web of Science ®Google Scholar
• Tiihonen J, Mittendorfer-Rutz E, Majak M, et al. Real-world effectiveness of antipsychotic treatments in a nationwide cohort of 29 823 patients with schizophrenia. JAMA Psychiatry. 2017;74:686–693.
   PubMed Web of Science ®Google Scholar
• Kishimoto T, Nitta M, Borenstein M, et al. Long-acting injectable versus oral antipsychotics in schizophrenia: a systematic review and meta-analysis of mirror-image studies. J Clin Psychiatry. 2013;74:957–965.
   PubMed Web of Science ®Google Scholar
• Kishimoto T, Hagi K, Nitta M, et al. Effectiveness of long-acting injectable vs oral antipsychotics in patients with schizophrenia: a meta-analysis of prospective and retrospective cohort studies. Schizophr Bull. 2018;44:603–619.
   PubMed Web of Science ®Google Scholar
• Brown JD, Barrett A, Caffery E, et al. State and demographic variation in use of depot antipsychotics by Medicaid beneficiaries with schizophrenia. Psychiatr Serv. 2014;65:121–124.
   PubMed Web of Science ®Google Scholar
• Lawson W, Johnston S, Karson C, et al. Racial differences in antipsychotic use: claims database analysis of Medicaid-insured patients with schizophrenia. Ann Clin Psychiatry. 2015;27:242–252.
   PubMed Web of Science ®Google Scholar
• Sultana J, Hurtado I, Bejarano-Quisoboni D, et al. Antipsychotic utilization patterns among patients with schizophrenic disorder: a cross-national analysis in four countries. Eur J Clin Pharmacol. 2019;75:1005–1015.
   PubMed Web of Science ®Google Scholar
• Patel C, Emond B, Morrison L, et al. Risk of subsequent relapses and corresponding healthcare costs among recently-relapsed Medicaid patients with schizophrenia: a real-world retrospective cohort study. Curr Med Res Opin. 2021;37:665–674.
   PubMed Web of Science ®Google Scholar
• Sun SX, Liu GG, Christensen DB, et al. Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin. 2007;23:2305–2312.
   PubMed Web of Science ®Google Scholar
• Nicholl D, Akhras KS, Diels J, et al. Burden of schizophrenia in recently diagnosed patients: healthcare utilisation and cost perspective. Curr Med Res Opin. 2010;26:943–955.
   PubMed Web of Science ®Google Scholar
• Horvitz-Lennon M, Volya R, Donohue JM, et al. Disparities in quality of care among publicly insured adults with schizophrenia in four large U.S. states, 2002-2008. Health Serv Res. 2014;49:1121–1144.
   PubMed Web of Science ®Google Scholar
• Olfson M, Marcus SC, Doshi JA. Continuity of care after inpatient discharge of patients with schizophrenia in the Medicaid program: a retrospective longitudinal cohort analysis. J Clin Psychiatry. 2010;71:831–838.
   PubMed Web of Science ®Google Scholar
• Patel C, Pilon D, Gupta D, et al. National and regional description of healthcare measures among adult Medicaid beneficiaries with schizophrenia within the United States. J Med Econ. 2022;25:792–807.
   PubMed Web of Science ®Google Scholar
• Khaykin E, Eaton WW, Ford DE, et al. Health insurance coverage among persons with schizophrenia in the United States. Psychiatric Serv. 2010;61:830–834.
   PubMed Web of Science ®Google Scholar
• Zhang Y, Baik SH, Newhouse JP. Use of intelligent assignment to Medicare Part D plans for people with schizophrenia could produce substantial savings. Health Aff. 2015;34:455–460.
   Web of Science ®Google Scholar
• Department of Health and Human Services. 45 CFR 46. HHS.Gov. 2016. [cited 2022 Dec 21]. https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html.
   Google Scholar
• Centers for Medicare and Medicaid Services. Hospital quality initiative: measure methodology. 2021. [cited 2022 Dec 21]. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Measure-Methodology.
   Google Scholar
• Centers for Medicare and Medicaid Services. Inpatient psychiatric facility quality reporting (IPFQR) program overview. n.d. [cited 2022 Dec 21]. https://qualitynet.cms.gov/ipf/ipfqr.
   Google Scholar
• National Committee for Quality Assurance. Adherence to antipsychotic medications for individuals with schizophrenia. NCQA. n.d. [cited 2023 Feb 23]. https://www.ncqa.org/hedis/measures/adherence-to-antipsychotic-medications-for-individuals-with-schizophrenia/.
   Google Scholar
• Peterson A, Nau D, Cramer J, et al. A checklist for medication compliance and persistence studies using retrospective databases. Value Health. 2007;10:3–12.
   PubMed Web of Science ®Google Scholar
• Campagna EJ, Muser E, Parks J, et al. Methodological considerations in estimating adherence and persistence for a long-acting injectable medication. J Manag Care Spec Pharm. 2014;20:756–766.
   PubMed Web of Science ®Google Scholar
• Elixhauser A, Steiner C, Harris DR, et al. Comorbidity measures for use with administrative data. Med Care. 1998;36:8–27.
   PubMed Web of Science ®Google Scholar
• Agency for Healthcare Research and Quality. Elixhauser comorbidity software, version 3.7. healthcare cost and utilization project (HCUP). 2017. [cited 2023 Feb 9]. https://www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp.
   Google Scholar
• Glick HA, Doshi JA, Sonnad SS, Polsky D, editors. Economic evaluation in clinical trials. 2nd ed. Oxford, New York: Oxford University Press; 2014.
   Google Scholar
• SAS Institute. SAS: analytics, artificial intelligence and data management. 2022. [cited 2022 Dec 21]. https://www.sas.com/en_us/home.html.
   Google Scholar
• Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annu Rev Clin Psychol. 2014;10:425–448.
   PubMed Web of Science ®Google Scholar
• Li P, Benson C, Geng Z, et al. Out-of-pocket costs for long-acting injectable and oral antipsychotics by low-income subsidy status of Medicare part D beneficiaries with schizophrenia. Presented at: American Society of Health-System Pharmacists 2022 Midyear Clinical Meeting and Exhibition; December 4-8, 2022; Las Vegas, NV. Poster 8-130.
   Google Scholar
• Keepers GA, Fochtmann LJ, Anzia JM, et al. The American psychiatric association practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry. 2020;177:868–872.
   PubMed Web of Science ®Google Scholar
• Barnes TRE. Schizophrenia consensus group of British association for psychopharmacology. Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2011;25:567–620.
   PubMed Web of Science ®Google Scholar
• Buchanan RW, Kreyenbuhl J, Kelly DL, et al. The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophr Bull. 2010;36:71–93.
   PubMed Web of Science ®Google Scholar
• Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand college of psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016;50:410–472.
   PubMed Web of Science ®Google Scholar
• Hasan A, Falkai P, Wobrock T, et al. World federation of societies of biological psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance. World J Biol Psychiatry. 2012;13:318–378.
   PubMed Web of Science ®Google Scholar
• National Collaborating Centre for Mental Health (UK). Psychosis and schizophrenia in adults: treatment and management. Updated ed. 2014. London: National Institute for Health and Care Excellence (UK); 2014.
   Google Scholar
• Remington G, Addington D, Honer W, et al. Guidelines for the pharmacotherapy of schizophrenia in adults. Can J Psychiatry. 2017;62:604–616.
   PubMed Web of Science ®Google Scholar
• Hamann J, Kissling W, Heres S. Checking the plausibility of psychiatrists׳ arguments for not prescribing depot medication. Eur Neuropsychopharmacol. 2014;24(9):1506–1510.
   PubMed Web of Science ®Google Scholar
• Heres S, Hamann J, Kissling W, et al. Attitudes of psychiatrists toward antipsychotic depot medication. J Clin Psychiatry. 2006;67(12):1948–1953.
   PubMed Web of Science ®Google Scholar
• Kirschner M, Theodoridou A, Fusar-Poli P, et al. Patients’ and clinicians’ attitude towards long-acting depot antipsychotics in subjects with a first episode of psychosis. Ther Adv Psychopharmacol. 2013;3:89–99.
   PubMedGoogle Scholar
• Galewitz P. Uber and Lyft ride-sharing services hitch onto Medicaid. Kaiser Health News; 2019. [cited 2023 Feb 8]. https://khn.org/news/uber-and-lyft-hitch-onto-medicaid/.
   Google Scholar
• National Council for Mental Wellbeing. CCBHC Locator. National Council for Mental Wellbeing 2021. [cited 2022 Dec 21]. https://www.thenationalcouncil.org/program/ccbhc-success-center/ccbhc-overview/ccbhc-locator/.
   Google Scholar
• National Alliance of State Pharmacy Associations. Pharmacist authority to administer long-acting antipsychotics. n.d. [cited 2022 Dec 21]. https://naspa.us/wp-content/uploads/2017/07/Pharmacists-Authority-to-Administer-Medications.pdf.
   Google Scholar
• Murugappan MN, Seifert RD, Farley JF. Examining Medicare Part D medication therapy management program in the context of mental health. J Am Pharm Assoc. 2020;60:571–579.e1.
   Google Scholar
• Yarmuth, JA. H.R.5376 - 117th Congress (2021-2022): Inflation Reduction Act of 2022. 2022. [cited 2022 Dec 20]. http://www.congress.gov/.
   Google Scholar