title: Comparison of rehospitalization rates and associated costs among patients with schizophrenia receiving paliperidone palmitate or oral antipsychotics.
abstract: OBJECTIVE
  Comparative data on rehospitalization patterns and associated institutional costs after inpatient treatment with paliperidone palmitate or oral antipsychotic therapy are reported.
  
  
  METHODS
  A retrospective cohort study was conducted using discharge and billing records from a large hospital database. Selected clinical and cost outcomes were compared in a cohort of adult patients who received the long-acting antipsychotic paliperidone palmitate during a schizophrenia-related index hospital stay and a cohort of patients who received oral antipsychotic therapy during their index admission. Inverse probability-of-treatment weights based on propensity scores were used to reduce confounding. Rates of all-cause and schizophrenia-related rehospitalization and emergency room (ER) use in the two cohorts over periods of up to 12 months were analyzed using a multivariate Cox proportional hazard model. Institutional costs for the evaluated postdischarge events were compared via multivariate linear regression analysis.
  
  
  RESULTS
  In the first 12 months after index hospital discharge, the risk of all-cause rehospitalization and ER use was significantly lower in the paliperidone palmitate cohort than in the oral antipsychotic cohort (hazard ratio, 0.61; 95% confidence interval [CI], 0.59-0.63; p < 0.0001); institutional costs during the first 6 months after discharge were significantly lower in the paliperidone palmitate cohort than in the comparator group (adjusted mean monthly cost difference -$404; 95% CI, -$781 to -$148; p < 0.0001).
  
  
  CONCLUSIONS
  The use of paliperidone palmitate therapy during patients' index hospital admission for schizophrenia was associated with a reduced risk of hospital readmission or ER use and lower postdischarge institutional costs.
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée. mlafeuille@analysisgroup.com.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Lafeuille
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: Amanda Melina
authors.initials: AM
authors.lastname: Grittner
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fortier
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: Erik
authors.initials: E
authors.lastname: Muser
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: John
authors.initials: J
authors.lastname: Fasteneau
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: Mei Sheng
authors.initials: MS
authors.lastname: Duh
authors.affiliation: Marie-Hélène Lafeuille, M.A., is Senior Economist; Amanda Melina Grittner, M.A., is Economist; and Jonathan Fortier, M.A., is Economist, Groupe d'analyse, Ltée, Montréal, Canada. Erik Muser, Pharm.D., M.P.H., is Associate Director, Translational Science; and John Fasteneau, M.P.H., is Senior Director, Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, NJ. Mei Sheng Duh, M.P.H., Sc.D., is Managing Principal,Analysis Group, Inc., Boston, MA. Patrick Lefebvre, M.A., is Vice President, Groupe d'analyse, Ltée.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lefebvre
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000191:economics* / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D000068882:Paliperidone Palmitate; D010168:Palmitates / Q000191:economics* / Q000627:therapeutic use*; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data*; D057216:Propensity Score; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*
chemical_list: D014150:Antipsychotic Agents; D007555:Isoxazoles; D010168:Palmitates; D000068882:Paliperidone Palmitate