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Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population
Joshi, K., Muser, E., Xu, Y., Schwab, P. E., Datar, M., & Suehs, B. (2018). Adherence and economic impact of paliperidone palmitate versus oral atypical antipsychotics in a Medicare population. Journal of Comparative Effectiveness Research, 7(8), 723-735. https://doi.org/10.2217/cer-2018-0003
Aim: To compare adherence, healthcare utilization and costs among real world, Medicare-eligible patients with schizophrenia using long-acting injectable paliperidone palmitate (PP) versus oral atypical antipsychotics. Patients & methods: Historical cohort study used Medicare Advantage claims data. Inverse probability of treatment weighting was applied to adjust for baseline differences. 12-month adherence, healthcare utilization and costs were compared. Results: Patients using PP were more adherent (proportion of days covered ≥0.8; 48.1 vs 32.6%; p < 0.001), had lower odds of hospitalization (odds ratio [OR]: 0.81; 95% CI: 0.68–0.96) and lower medical costs ($11,095; 95% CI: $10,374–11,867 vs $15,551; 95% CI: $14,584–16,583), but higher pharmacy costs ($14,787; 95% CI: $14,117–15,488 vs $5781; 95% CI: $5530–6043). Conclusion: Compared with patients using oral atypical antipsychotics, PP had lower hospitalizations and medical costs with greater medication adherence accompanied by higher pharmacy costs.
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