Impact of switching to long-acting injectable antipsychotics on health services use in the treatment of schizophrenia

Jean Lachaine, Marie Eve Lapierre, Nadine Abdalla, Alice Rouleau, Emmanuel Stip

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

OBJECTIVE: To better understand the treatment patterns, persistence and compliance, resource use, and associated costs, of long-acting injectable antipsychotics (LAI-AP), using the Régie de l'assurance maladie du Québec database.

METHOD: Patients with schizophrenia or schizoaffective disorder who were incident users of an LAI-AP prescribed between January 1, 2008, and March 31, 2012, were selected. Concomitant use of oral APs and treatment persistence and compliance with LAI-AP were analyzed. Patients were considered compliant if they had a medication possession ratio (MPR) of at least 0.80. Health care resource use (HCRU) and associated costs were analyzed during the year before and after LAI-AP initiation.

RESULTS: A total of 1992 patients met the inclusion criteria. The average persistence with LAI-AP was 217.2 days (SD 144.2). The mean MPR with LAI-AP during the postinitiation year was 0.58 (SD 0.35), with 37.5% of patients being compliant. In the preinitiation year, 29.0% of patients were compliant with previous oral AP. In the pre- and postinitiation periods, 1484 and 958 patients had at least 1 hospitalization, and hospitalized days were reduced by one-half (P<0.001). Cost of HCRU, including medication, was significantly decreased from $24,382 (SD $27,234) to $13,090 (SD $16,987), respectively, in the pre- and postinitiation years (P<0.001).

CONCLUSIONS: The initiation of an LAI-AP improved treatment compliance, compared with previous oral APs, resulted in significantly lower HCRU and costs. The primary drivers were the reduction in the occurrence and days of hospitalizations.

Original languageEnglish
Pages (from-to)S40-S47
JournalCanadian Journal of Psychiatry
Volume60
Issue number3
Publication statusPublished - Mar 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health

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