Abstracts
3427237
(#49) Impact of Adherence on Post-Discharge Outcomes With Long-Acting Injectable Olanzapine Pamoate or Paliperidone Palmitate After Schizophrenia Hospitalization
Abstract: Background: Olanzapine is highly efficacious for schizophrenia and has been associated with lower discontinuation than several other antipsychotics. Its long‑acting injectable (LAI) formulation, olanzapine pamoate (OP), can extend these benefits but remains underused, likely due to monitoring requirements for post‑injection delirium/sedation syndrome (PDSS), which may impact adherence. This study evaluated real‑world adherence to OP vs paliperidone palmitate (PP), as well as effectiveness among adherent patients.
Methods: Medicare claims data (2017-2022) identified adults hospitalized for schizophrenia with an OP/PP claim ≤3 months post-discharge. In propensity score-matched groups, outcomes included quality measures of patient engagement, all-cause readmission (both 30/60 days post-discharge), and adherence (proportion of days covered [PDC]; 'high' adherence, ≥0.8), along with discontinuation, healthcare resource utilization (HCRU), and costs (all 6 months post-treatment initiation). Subgroups with PDC ≥0.5 were also examined.
Results: OP (n=192) was associated with lower prevalence of high adherence and higher discontinuations than PP (n=957) (both P 0.0001), along with lower engagement, higher readmissions, and greater HCRU and costs (all P≤0.0082). Among subgroups with PDC ≥0.5, OP (n=46) demonstrated lower mean all-cause inpatient visits per patient (0.17 vs 0.38; P=0.0275), schizophrenia-specific costs ($15,535 vs $20,314; P=0.0069), and numerically lower all-cause costs ($23,546 vs $30,393; P=0.0814) than PP (n=568).
Conclusions: Together with prior literature, findings suggest lower adherence to OP vs other LAIs, with PDSS-related risk/monitoring requirements as potential contributors. However, among the small number of OP-adherent patients, olanzapine's established efficacy appears preserved. Findings indicate an unmet need for an olanzapine LAI that improves adherence and clinical outcomes.
Short Description: In this real-world Medicare claims analysis, long-acting injectable (LAI) olanzapine pamoate (OP) was associated with poorer outcomes following schizophrenia hospitalization than paliperidone palmitate (PP), including lower patient engagement, higher readmission, and greater healthcare resource utilization and costs, alongside lower adherence and higher discontinuation. However, among those with higher adherence, OP was associated with lower inpatient visits and costs than PP. Findings indicate a need for an olanzapine LAI that improves adherence and optimizes clinical outcomes.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
Methods: Medicare claims data (2017-2022) identified adults hospitalized for schizophrenia with an OP/PP claim ≤3 months post-discharge. In propensity score-matched groups, outcomes included quality measures of patient engagement, all-cause readmission (both 30/60 days post-discharge), and adherence (proportion of days covered [PDC]; 'high' adherence, ≥0.8), along with discontinuation, healthcare resource utilization (HCRU), and costs (all 6 months post-treatment initiation). Subgroups with PDC ≥0.5 were also examined.
Results: OP (n=192) was associated with lower prevalence of high adherence and higher discontinuations than PP (n=957) (both P 0.0001), along with lower engagement, higher readmissions, and greater HCRU and costs (all P≤0.0082). Among subgroups with PDC ≥0.5, OP (n=46) demonstrated lower mean all-cause inpatient visits per patient (0.17 vs 0.38; P=0.0275), schizophrenia-specific costs ($15,535 vs $20,314; P=0.0069), and numerically lower all-cause costs ($23,546 vs $30,393; P=0.0814) than PP (n=568).
Conclusions: Together with prior literature, findings suggest lower adherence to OP vs other LAIs, with PDSS-related risk/monitoring requirements as potential contributors. However, among the small number of OP-adherent patients, olanzapine's established efficacy appears preserved. Findings indicate an unmet need for an olanzapine LAI that improves adherence and clinical outcomes.
Short Description: In this real-world Medicare claims analysis, long-acting injectable (LAI) olanzapine pamoate (OP) was associated with poorer outcomes following schizophrenia hospitalization than paliperidone palmitate (PP), including lower patient engagement, higher readmission, and greater healthcare resource utilization and costs, alongside lower adherence and higher discontinuation. However, among those with higher adherence, OP was associated with lower inpatient visits and costs than PP. Findings indicate a need for an olanzapine LAI that improves adherence and optimizes clinical outcomes.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
