title: Exploratory analysis of psychiatric-related utilization and costs associated with paliperidone ER compared with other oral atypical antipsychotics using pharmacy claims from an administrative database.
abstract: OBJECTIVE
  To compare psychiatric-related healthcare resource utilization (inpatient facility admissions, emergency room visits and ambulatory visits) and costs (medical, pharmacy and total healthcare costs) in patients initiated on paliperidone extended release (ER), risperidone, aripiprazole, olanzapine, ziprasidone or quetiapine.
  
  
  METHODS
  This exploratory, retrospective administrative claims analysis database compared patients from a large US commercial health plan who were initiated on their index oral atypical antipsychotics between January 1, 2007, and June 30, 2007. Cohorts were assigned by first antipsychotic claim and propensity score-matched by age, gender, US census division, race, household income, baseline antipsychotic use, co-morbid conditions and psychiatric-related utilization. Psychiatric-related healthcare resource utilization and costs were measured for 6 months post-initiation. Descriptive analyses compared paliperidone ER with the other cohorts.
  
  
  RESULTS
  There were 562 patients in matched paliperidone ER (n = 95), risperidone (n = 94), aripiprazole (n = 94), olanzapine (n = 89), ziprasidone (n = 95) or quetiapine (n = 95) cohorts. The paliperidone ER cohort had fewer mean psychiatric-related ambulatory visits than the risperidone cohort (p = 0.05). The paliperidone ER cohort had significantly lower mean psychiatric-related medical costs than the olanzapine, quetiapine and ziprasidone cohorts (p < 0.05) and lower total costs than the ziprasidone and olanzapine cohorts (p = 0.02). No other outcomes were significantly different.
  
  
  CONCLUSIONS
  Small sample sizes and short post-index observation times due to the launch of paliperidone ER in January 2007, coupled with the inherent lag time with medical claims data, limit the generalizability of the study findings.
  
  
  CONCLUSIONS
  Patients treated with paliperidone ER may have psychiatric-related utilization costs that are comparable to those of patients who initiated treatment with other oral atypical antipsychotics.
authors.affiliation: Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ 08560, USA. JPanish@its.jnj.com
authors.forename: J M
authors.initials: JM
authors.lastname: Panish
authors.forename: R
authors.initials: R
authors.lastname: Dirani
authors.forename: R
authors.initials: R
authors.lastname: Halpern
authors.forename: F
authors.initials: F
authors.lastname: Cao
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use; D015897:Comorbidity; D003692:Delayed-Action Preparations; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007555:Isoxazoles / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D008875:Middle Aged; D000068882:Paliperidone Palmitate; D010343:Patient Admission / Q000706:statistics & numerical data; D011743:Pyrimidines / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D007555:Isoxazoles; D011743:Pyrimidines; D000068882:Paliperidone Palmitate