Aripiprazole once monthly extended release associated with less risk of hospitalization compared to other injectables
Aripiprazole once monthly extended release appears to be more effective than haloperidol and risperidone long acting injectables in reducing hospitalization risk in patients with schizophrenia and bipolar disorder, a new US study reveals.
The study, which appeared in the October issue of Current Medical Research and Opinion journal, looked at all-cause hospitalizations and associated costs among patients with schizophrenia and bipolar disorder who received long-acting injectable antipsychotics (LAIs). They compared hospitalization rates for both disorders when treated with risperidone, haloperidol and aripiprazole.
The study utilized data from Truven Health Analytics MarketScan® Medicaid claims database to identify patients with schizophrenia. For patients with bipolar disorder, claims data from Truven Medicaid and commercial databases were used. Adult patients with more than one long acting injectable antipsychotics claims within the stipulated period were identified and followed for more than 1 year. Data collected were then analyzed using logistic and general linear regression models in order to estimate risk of hospitalization and associated costs.
It was revealed that the risks of hospitalization were significantly higher in the patients treated with haloperidol [OR, 95% CI:1.51 (1.05–2.16), HR(95% CI):1.35(1.05–1.73)] and risperidone [OR (95% CI): 1.58 (1.07–2.33); HR (95% CI): 1.33 (1.01–1.74)] compared with patients treated with aripiprazole. The results were similar in patients with bipolar disorder, where risks of hospitalization in haloperidol [OR (95% CI): 1.49 (1.01–2.19); HR (95% CI): 1.33 (1.03–1.73)]and risperidone [OR (95%
CI): 1.78 (1.19–2.66); HR (95% CI): 1.33 (1.01–1.75)] were significantly higher than patients treated with aripiprazole. However, it was noted that there was no statistical significance in hospitalization costs observed in either disease groups ie, once hospitalized, treatment costs were similar regardless of therapy used.
The paper concluded that aripiprazole may be more effective than haloperidol and risperidone long acting injectable antipsychotics in preventing hospitalization among patients with schizophrenia and bipolar disorder.
Schizophrenia and bipolar disorder are serious and chronic mental disorders. Both conditions are associated with vastly decreased quality of life and personal suffering. On a wider perspective, they impart substantial economic burden in terms of direct and indirect healthcare costs. In the US, schizophrenia and bipolar disorder affects 1.1 percent and 2.6 percent of the population, respectively.
One of the major contributors to healthcare cost attributed to schizophrenia and bipolar disorder is hospitalization. Hospitalization is a used as a proxy for relapse, which contributes up to two-thirds of the cost of treatment for patients with schizophrenia and more than one quarter of direct costs of treatment for patients with bipolar disorder.