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The Incidence and Economic Burden of Extrapyramidal Symptoms in Patients with Schizophrenia Initiating Atypical Antipsychotics in a Commercially Insured Population

Published online by Cambridge University Press:  28 April 2022

Aditi Kadakia ,
Brenna Brady ,
Carole Dembek ,
Rhys Williams  and
Justine Kent
Aditi Kadakia
Affiliation:
Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
Brenna Brady
Affiliation:
IBM Watson Health, Cambridge, MA, USA
Carole Dembek
Affiliation:
Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
Rhys Williams
Affiliation:
Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
Justine Kent
Affiliation:
Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
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Abstract

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Background

Extrapyramidal symptoms (EPS) affect 15% to 30% of patients with schizophrenia treated with antipsychotics and have been associated with poor patient outcomes.

Objectives

To examine the incidence and economic burden of EPS in patients with schizophrenia initiating treatment with atypical antipsychotics (AAPs).

Methods

Patients with schizophrenia newly initiating AAPs with no prior EPS were identified in the MarketScan Commercial and Medicare Supplemental database from January 1, 2012 to December 31, 2018. Incidence of EPS (new diagnosis or medication) was assessed in the year following AAP initiation. Patients were classified as developing (EPS cohort) or not developing (non-EPS cohort) EPS. All-cause and schizophrenia-related healthcare resource use and costs were compared between cohorts over the year following the first EPS claim (EPS) or randomly assigned index date (non-EPS). Multivariate models were developed for total healthcare costs and inpatient admissions.

Results

A total of 3558 patients qualified for the study; 22.1% developed EPS in the year following AAP initiation (incidence: 26.9 cases/100-person-years). Multivariate analyses demonstrated that EPS patients had a 34% higher odds of all-cause (OR:1.3361, 95% CI:1.0770-1.6575, P < .01) and 84% increased odds of schizophrenia-related (OR:1.8436, 95% CI:1.0434-2.4219, P < .0001) inpatient admissions, as well as significantly higher all-cause (EPS: $26,632 vs non-EPS: $21,273, P < .001) and schizophrenia-related (EPS: $9018 vs non-EPS: $4475, P < .0001) total costs compared to the non-EPS cohort.

Conclusions

Approximately 20% of patients developed EPS in the year following AAP initiation. The significant increases in healthcare resource utilization and costs in the EPS cohorts highlight the need for treatments that effectively target schizophrenia symptoms while reducing the risk of EPS.

Funding

Sunovion Pharmaceuticals

Type
Abstracts
Information
CNS Spectrums , Volume 27 , Issue 2 , April 2022 , pp. 228
Copyright
© The Author(s), 2022. Published by Cambridge University Press