Antipsychotic Nonadherence, Switching Raise Schizophrenia Treatment Costs

Among patients with schizophrenia in the United States, adherence to antipsychotic medication is low and discontinuation high, according to a systematic review published in Advances in Therapy.

“Therefore, many patients living with schizophrenia have symptoms that may not be optimally managed, leading to higher treatment costs when subsequent efforts aimed at reducing those symptoms include switches in treatment and/or augmentation with additional agents,” researchers advised.

The investigation included 81 observational, real-world studies that looked at patterns of oral antipsychotic treatment and associated costs for US adults with schizophrenia. Olanzapine, risperidone, and quetiapine were the oral second-generation antipsychotics prescribed most frequently.

Fewer than 50% of patients took their antipsychotic medication 80% of more of the time, the review found. Nearly half of patients switched antipsychotics, and as many as 29% had an additional antipsychotic added to their treatment regimen. Suboptimal adherence, antipsychotic switching, and antipsychotic augmentation were all linked with higher costs compared with high adherence and not requiring a medication switch or augmentation.

Patients who did not adhere to antipsychotic treatment had annual medical costs averaging $10,316, compared with $5723 in patients who adhered to treatment. The costs of immediate or delayed switching of antipsychotic medications were between $21,922 and $28,232, the study showed. Meanwhile, the costs of augmenting with an additional antipsychotic ranged from $24,045 to $29,344.

“Despite the number of available oral antipsychotics for schizophrenia, there remains an unmet need for new, highly efficacious treatments that may improve adherence,” researchers wrote. “Such treatments may decrease health care resource utilization and the overall cost burden associated with schizophrenia over time.”

Reference:
Martin A, Bessonova L, Hughes R, et al. Systematic review of real-world treatment patterns of oral antipsychotics and associated economic burden in patients with schizophrenia in the United States. Adv Ther. Published online July 18, 2022. doi:10.1007/s12325-022-02232-z