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No differences found in utilization, costs between paliperidone palmitate monotherapy, adjunctive therapy

Results presented in a poster at the U.S. Psychiatric and Mental Health Congress indicate no significant differences in health care utilization and total costs between paliperidone palmitate monotherapy and adjunctive therapy for individuals with schizoaffective disorder.

To assess all-cause and mental health-related utilization and costs associated with once-monthly paliperidone palmitate monotherapy and paliperidone palmitate adjunctive therapy, researchers analyzed health insurance claims from the 2009 to 2012 MarketScan Medicaid multi-state databases for individuals aged 18 years or older with schizoaffective disorder. The final study cohort included 466 patients with claims for monotherapy and 854 with claims for adjunctive therapy. The mean age of the monotherapy cohort was 36 years vs. 39 years in the adjunctive therapy cohort.

Overall, researchers found no significant differences in measured cost and utilization outcomes between patients in the monotherapy cohort and adjunctive therapy cohort, with the exception of mental health–related drug costs.

Patients in the adjunctive therapy cohort had lower mean per-patient monthly mental health-related drug costs (–$152; 95% CI, –$295 to –$10) compared with patients in the monotherapy cohort.

“While patients receiving adjunctive therapy would be expected to have higher mental health-related drug costs than patients receiving one drug, the analysis showed the opposite was true,” the researchers wrote in their poster. “Discontinuation for [paliperidone palmitate] could account for the [monotherapy] cohort having lower mental health–related drug costs than the [adjunctive therapy] cohort, as discontinuation results in a drop of $1,083.98 in the [monotherapy] cohort and $774.08 in the [adjunctive therapy] cohort.”

Because of this, the researchers speculated that the difference in mental health–related drug costs may be due to chance as a result of multiplicity of testing.

“After using robust statistical methods to control for differences between cohorts both at index and over the study period, the study found no significant differences in utilization and total costs between [monotherapy] and [adjunctive therapy] costs,” the researchers concluded. – by Amanda Oldt

Reference:

Pesa JA, et al. Health care resource utilization and costs associated with paliperidone palmitate monotherapy versus adjunctive therapy among Medicaid patients with schizoaffective disorder. Presented at: U.S. Psychiatric and Mental Health Congress; Sept. 10-13, 2015; San Diego.

Disclosure: The study was supported by Janssen Scientific Affairs, LLC. Pesa reports employment at Janssen Scientific Affairs, LLC. Please see the full study for a list of all other authors’ disclosures.