title: Impact of initiation of asenapine on patterns of utilization and cost of healthcare resources associated with the treatment of bipolar I disorder.
abstract: OBJECTIVE
  To assess the impact of initiation of asenapine on "real-world" levels of utilization and cost of healthcare services for the treatment of bipolar I disorder (BPD) in the US.
  
  
  METHODS
  Using two large US healthcare claims databases that collectively included commercially insured patients aged < 65 years and Medicare enrollees, this study identified all adults (≥ 18 years) with evidence of BPD who began therapy with asenapine between 2009-2012. The date of the earliest claim for asenapine during this period was deemed the 'index date', and patients without continuous enrollment for the 6-month periods before and after this date were excluded ('pre-index' and 'post-index', respectively). Healthcare claims with a BPD diagnosis, plus psychiatric medications and the costs thereof (2012 dollars) were deemed 'BPD-related'. Differences in BPD-related utilization and cost of healthcare services were compared between the pre- and post-index periods.
  
  
  RESULTS
  A total of 1403 patients met all selection criteria; the mean age was 42.8 years and 70.6% were women. Relative to pre-index, significant decreases were noted in post-index use of BPD-related healthcare services, most notably admissions (from 24.0% to 12.3% during the post-index period) and emergency department visits (from 4.6% to 2.6%) (both p < 0.05). While pharmacy costs increased, mean total post-index BPD-related healthcare costs were $979 lower than pre-index ($5002 vs $5981; p < 0.05), primarily due to the decrease in BPD-related admissions.
  
  
  CONCLUSIONS
  Relative to the 6-month period beforehand, levels of utilization of BPD-related healthcare services and costs decreased during the 6-month period immediately following initiation of asenapine therapy.
authors.affiliation: a a Evidera , Lexington , MA , USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Chitnis
authors.affiliation: a a Evidera , Lexington , MA , USA.
authors.forename: Rosa
authors.initials: R
authors.lastname: Wang
authors.affiliation: b b Forest Research Institute , Jersey City , NJ , USA.
authors.forename: Shawn X
authors.initials: SX
authors.lastname: Sun
authors.affiliation: b b Forest Research Institute , Jersey City , NJ , USA.
authors.forename: Shailja
authors.initials: S
authors.lastname: Dixit
authors.affiliation: a a Evidera , Lexington , MA , USA.
authors.forename: Alie
authors.initials: A
authors.lastname: Tawah
authors.affiliation: a a Evidera , Lexington , MA , USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Boulanger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000191:economics*; D015897:Comorbidity; D003986:Dibenzocycloheptenes; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006576:Heterocyclic Compounds, 4 or More Rings / Q000008:administration & dosage / Q000627:therapeutic use*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; C522667:asenapine
keywords: Asenapine; Bipolar I disorder; Healthcare cost; Healthcare utilization