title: A cost-consequence analysis of long-acting injectable risperidone in schizophrenia: a one-year mirror-image study with national claim-based database in Taiwan.
abstract: OBJECTIVE
  The development of long-acting atypical antipsychotics has provided a new paradigm for schizophrenia treatment. The economic effectiveness of risperidone long-acting injection (RLAI) on service costs has, however, never been studied in the real world with national claim-based database.
  
  
  METHODS
  To assess the change of service utilization and costs for schizophrenia before and after RLAI treatment, we conducted this 1-year mirror-image study with Taiwanese national claimed-data. Comparison was made for service sectors (the number of visits, acute admissions and relapse events) and cost components (outpatient, inpatient, emergency, medication and non-medication costs).
  
  
  RESULTS
  Service uses reduced in the post-RLAI period, along with a reduction of 34% and 32% on total inpatient services costs and inpatient non-medication costs, respectively (p < 0.005). However, overall psychiatric service costs went up by 26%, with an increase of 190% on total outpatient service costs and 177% on overall medication costs (p < 0.0001).
  
  
  CONCLUSIONS
  This 1-year mirror-image analysis showed that RLAI treatment was associated with reductions of service uses; however, overall psychiatric service costs were compromised by costs incurred from increased utilization of outpatient service and RLAI medication costs under the context of healthcare in Taiwan.
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taiwan.
authors.forename: Hui-Chih
authors.initials: HC
authors.lastname: Chang
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.forename: Sheng-Tzu
authors.initials: ST
authors.lastname: Huang
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: Kuan-Pin
authors.initials: KP
authors.lastname: Su
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007267:Injections / Q000191:economics; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D018967:Risperidone / Q000008:administration & dosage* / Q000191:economics; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*; D013624:Taiwan; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone