Medication Adherence and Healthcare Resource Utilization in South Carolina Medicaid Beneficiaries with Schizophrenia or Schizoaffective Disorder: Long-acting Injectable vs. Oral Antipsychotics

Abstract: Background: Schizophrenia requires long-term treatment with antipsychotics; however, poor adherence to antipsychotic treatment can result in increased healthcare resource utilization, placing a burden on the healthcare system. Long-acting injectable antipsychotics (LAI) offer a promising solution, requiring less frequent dosing and potentially improving medication adherence compared to oral antipsychotics (OAP). Methods: This study compared the effectiveness of LAI versus OAP among adult South Carolina Medicaid beneficiaries aged between 18 and 65 years. Propensity scores (PS) were calculated to adjust for potential confounders. The study conducted an average treatment effect among the treated (ATT) PS-weighted comparison of medication adherence in the post-index year. Results: The study included 3,531 patients, of whom 1,537 received LAI and 1,994 received OAP. The results showed that LAI was associated with significantly better medication adherence, with a higher proportion of days covered (69% vs. 64%) and greater persistence (85% vs. 80%) than OAP. Patients in the LAI group were also more likely to refill their index prescription. Patients in the LAI group were more likely to be hospitalized in the weighted analysis, but among hospitalized patients, the LAI group had an 18% lower frequency of hospitalization than the OAP group. Conclusion: LAI offers a potential solution to improve medication adherence and reduce healthcare resource utilization in patients with schizophrenia. Therefore, healthcare providers should consider LAI as a viable treatment option for patients with schizophrenia or schizoaffective disorder to improve the quality of care and reduce the burden on the healthcare system.Short Description: This study evaluated the effect of long-acting injectables (LAI) versus oral antipsychotics (OAP) use on medication adherence and healthcare resource utilization among South Carolina (SC) Medicaid beneficiaries with schizophrenia. The study provides evidence that LAI antipsychotic medications are associated with greater medication adherence and lower all-cause and schizophrenia-related hospitalizations than OAPs. These findings have significant implications for treating schizophrenia and suggest that LAI antipsychotics may be a more effective option for managing the disease.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC