title: Hospitalizations and economic analysis in psychotic patients with paliperidone palmitate long-acting injection.
abstract: OBJECTIVE
  Prevent hospitalizations in psychotic disorders is an important aim, so long-acting antipsychotic is a good option that can control better the correct adherence. Moreover, in the current economic context pharmacoeconomic studies are necessary. We estimate the effect in prevention of paliperidone palmitate long-acting injection (PP-LAI) and calculate the economic cost in the 12 months preceding the start of treatment with PP-LAI and 12 months later.
  
  
  METHODS
  Mirror image study of 71 outpatients diagnosed with psychotic disorders and treated with PP-LAI. In a first analysis, we measured along one year: number of hospitalizations/year, number of hospitalization in days, number of emergency assists/year and if there is antipsychotics associated to long-acting treatment. After this phase, we applied Fees Act of Valencia for economic analysis and estimate of the cost per hospitalization (€ 5,640.41) and hospital emergency (€ 187.61).
  
  
  RESULTS
  After one year of treatment with PP-LAI (mean dose=130.65mg/month), we obtained greater numbers in assistance variables: total hospitalizations decrease, 78.8% (P=.009); shortening in hospitalization days, 89.4% (P=.009); abridgement of number of emergency assists, 79.1% (P=.002); decrease of rate of antipsychotics associated to long-acting treatment, 21% (P<.0001); increase in monotherapy, 53.8% (P<.0001). Therefore, after 12 months of treatment with PP-LAI we obtained a reduction in inpatient spending (savings of € 175,766.54) and increased spending on antipsychotics 32% (equivalent to € 151,126.92).
  
  
  CONCLUSIONS
  PP-LAI can be an effective therapy for the treatment of patients with severe psychotic disorders: improves symptomatic stability and can prevent hospitalizations with cost-effective symptom control.
authors.affiliation: Servicio de Psiquiatría, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España; Centro de Salud Mental de La Mata, Torrevieja, Alicante, España. Electronic address: jemesones@torrevieja-salud.com.
authors.forename: Jesús E
authors.initials: JE
authors.lastname: Mesones-Peral
authors.affiliation: Hospital de la Marina Baixa, Villajoyosa, Alicante, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Gurillo-Muñoz
authors.affiliation: Centro de Salud Mental de La Mata, Torrevieja, Alicante, España.
authors.forename: Mari Paz
authors.initials: MP
authors.lastname: Sánchez-Sicilia
authors.affiliation: Servicio de Psiquiatría, Hospital Universitario de Torrevieja, Torrevieja, Alicante, España.
authors.forename: Adam
authors.initials: A
authors.lastname: Miller
authors.affiliation: Centro de Salud Mental de La Mata, Torrevieja, Alicante, España.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Griñant-Fernández
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D000068882:Paliperidone Palmitate / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000191:economics; D013030:Spain; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D000068882:Paliperidone Palmitate
keywords: Antipsicóticos; Antipsychotics; Cost; Coste; Esquizofrenia; Farmacoeconomía; Pharmacoeconomics; Psicosis; Psychosis; Schizophrenia