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Real-world evidence of improved healthcare utilization in patients with schizophrenia or schizoaffective disorder after early treatment of paliperidone palmitate once-monthly treatment in Hong Kong.
Choon, June W Y; Wu, David B C; Chong, H Y; Lo, William T L; Chong, Catherine S Y; Chung, W S; Chui, Eileena M C; Tomlinson, Brian; Lee, Vivian W Y; Lee, S C; Lee, Kenneth K C.
Afiliação
  • Choon JWY; a School of Pharmacy , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia.
  • Wu DBC; a School of Pharmacy , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia.
  • Chong HY; b Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia.
  • Lo WTL; a School of Pharmacy , Monash University Malaysia , Bandar Sunway , Selangor , Malaysia.
  • Chong CSY; c Kwai Chung Hospital , Hong Kong , PR China.
  • Chung WS; c Kwai Chung Hospital , Hong Kong , PR China.
  • Chui EMC; d Tai Po Hospital , Hong Kong , PR China.
  • Tomlinson B; e Queen Mary Hospital , Hong Kong , PR China.
  • Lee VWY; f Prince of Wales Hospital , Hong Kong , PR China.
  • Lee SC; g School of Pharmacy , the Chinese University of Hong Kong , Hong Kong , PR China.
  • Lee KKC; f Prince of Wales Hospital , Hong Kong , PR China.
J Med Econ ; 22(3): 273-279, 2019 Mar.
Article em En | MEDLINE | ID: mdl-30561238
BACKGROUND: Very few data are available to demonstrate the economic benefit of early paliperidone palmitate once-monthly long-acting injectable (PP1M) treatment in patients with schizophrenia or schizoaffective disorder. METHODS AND MATERIALS: This study has retrospectively compared the healthcare utilization and associated costs of pre- and post-PPIM treatment in 413 patients with schizophrenia or schizoaffective disorder recruited from three major public hospitals providing psychiatric services in Hong Kong. Patients were categorized into early treatment (≤3 years since diagnosis) and chronic (>3 years) groups, and also whether they were receiving polypharmacy (POP). RESULTS: It was found that patients who were started on early therapy with no POP had the most favourable outcomes. Overall results of the entire cohort, including both early and late treatments, indicate that there was a slight increase in annual in-patient days (IP) per patient and outpatient visit (OP) by 3.18 and 1.87, respectively, and a decrease in emergency room visit (ER) of 0.9 (p < 0.05). For non-polypharmacy (NP) patients receiving early PP1M therapy, there was a significant decrease in IP and ER of 21.56 (p < 0.05) and 1.15 (p < 0.05), respectively, but an increase in OP of 1.88 (p < 0.05). For patients with POP, there was an all-across increase in IP and all-across decrease in OP and ER. In monetary terms, a NP patient receiving early therapy may have an overall saving of HKD40,878 (USD5,241, 1USD = 7.8HKD) per year compared to HKD6,224 (USD798) in patients where therapy was given after 3 years. For patients with POP, there was an all-across increase in overall spending despite reductions in OP and ER. CONCLUSIONS: From the 413 patients studied, potential annual savings is higher by early administration of PPIM in patients with NP. Analysis using multivariate linear regression based on generalized estimating equations and sensitivity analysis using a linear mixed model supported the findings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos Psicóticos / Esquizofrenia / Antipsicóticos / Aceitação pelo Paciente de Cuidados de Saúde / Palmitato de Paliperidona Tipo de estudo: Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Implementation_research Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: J Med Econ Assunto da revista: SERVICOS DE SAUDE Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Malásia País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtornos Psicóticos / Esquizofrenia / Antipsicóticos / Aceitação pelo Paciente de Cuidados de Saúde / Palmitato de Paliperidona Tipo de estudo: Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Implementation_research Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: J Med Econ Assunto da revista: SERVICOS DE SAUDE Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Malásia País de publicação: Reino Unido