Hospitalisierungen und Behandlungskosten von Schizophreniepatienten nach Umstellung auf Depot-Antipsychotika

Zusammenfassung

Ziel der Studie Aktualisierte Untersuchung von Auswirkungen einer Initiierung von Depot-Antipsychotika-Therapie (LAI, long-acting injectable antipsychotic) auf die Hospitalisierungsraten und Therapiekosten deutscher Schizophrenie-Patienten.

Methodik Retrospektive Mirror-Image-Design-Studie der Kassendaten von 1142 deutschen Schizophrenie-Patienten, die in den Jahren 2013 bis 2016 eine Behandlung mit LAIs begonnen haben. Für die eingeschlossenen Patienten wurden die Kosten und Ressourcenverwendung 12 Monate vor dem Index-Datum (Erstinitiierung des LAI) und 12 Monate nach dem Index-Datum verglichen. Zur Bewertung von Krankenhausaufenthalten und deren Kosten wurden 2 Modelle verwendet. In Modell 1 wurde der Krankenhausaufenthalt während des Indexdatums dem Prä-Index-Zeitintervall zugeordnet, in Modell 2 weder dem Prä- noch dem Post-Index-Zeitintervall.

Ergebnisse Die Medikationskosten waren nach der Umstellung auf LAIs signifikant höher (3863,9 € vs. 777,6 €; p < 0,001). Die Anzahl und Dauer der Hospitalisierungen sowie die damit assoziierten Kosten waren nach der Umstellung auf LAIs bei Berechnung nach Modell 1 signifikant niedriger als im Zeitraum vor der Umstellung (2,4 vs. 2,6; 61,1 vs. 74,8 Tage; 5515,9 € vs. 12 502,7 €, alle p < 0,001). Dadurch waren auch die Gesamtkosten signifikant geringer (10 578,6 € vs. 12 459,4 €; p < 0,001). Die Ergebnisse nach Modell 2 zeigten einen ähnlichen Trend, jedoch war hier nur die Reduktion der assoziierten Kosten statistisch signifikant.

Schlussfolgerung In der analysierten Kohorte deutscher Schizophrenie-Patienten fanden wir Hinweise darauf, dass die Umstellung der Behandlung auf LAIs mit einer signifikant geringeren Rate an Hospitalisierungen und signifikant geringeren Gesamtkosten einhergeht.

Abstract

Objective Updated investigation of the effects of an initiation of a LAI therapy on hospitalization rates and therapy costs of German Schizophrenia patients.

Methods Retrospective mirror-image design study of claims data of 1,142 German schizophrenia patients who initiated treatment with LAIs during 2013–2016. For the included patients, costs and resource utilization were compared 12 months before the index date (first initiation of LAI) and 12 months after the index date. Two models were used to evaluate hospital stays and their costs. In model 1, the hospital stay during the index date was assigned to the pre-index time interval, whereas in model 2 it was assigned to neither the pre nor the post-index time interval.

Results Medication costs were significantly higher after the switch to LAIs (€3,863.9 vs. €777.6; p < 0.001). In model 1 the number and duration of hospitalizations and associated costs were significantly lower after the switch to LAIs (2.4 vs. 2.6; 61.1 vs. 74.8 days; 5,515.9 € vs. 12,502.7 €, all p < 0.001). Consequently, the total cost of schizophrenia therapy after conversion to LAIs was significantly lower in model 1 than in the period before conversion (10,578.6 € vs. 12,459.4 €; p < 0.001). The results in model 2 showed a similar trend. However only the reduction of the associated costs was statistically significant.

Conclusion In the analyzed cohort of German schizophrenia patients, we found evidence that the initiation of treatment with LAIs leads to a reduction in the hospitalization rate and overall costs.

Schlüsselwörter

Schizophrenie - Kostenanalyse - Ressourcenverbrauch - Routinedatenanalyse

Key words

schizophrenia - cost analysis - health resource utilization - claims data analysis

Publication History

Article published online:
03 August 2021

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