(#44) Longitudinal Real-World Study of the Patient Journey of a National Sample of Beneficiaries with Schizophrenia Dually Eligible for Medicare & Medicaid

Abstract: Introduction: Almost half of US patients with schizophrenia are dual eligibles; however, there is limited understanding of their journey in terms of receipt of long-acting injectable antipsychotic (LAI) treatment, clinical outcomes, and health resource utilization patterns over time. Methods: This descriptive analysis used 2006-2021 national Medicare and Medicaid claims to identify all dually eligible beneficiaries with ?1 medical claim with their first diagnosis of schizophrenia followed by ?1 antipsychotic (AP) prescription claim between 2009 and 2018. Outcomes included LAI use, type and number of prior oral antipsychotic (OAP) use, number of hospitalizations, ER visits, and relapses before and after LAI initiation. Results: Over a median follow-up of 5.6 years from AP initiation, only 35.9% of the 25,356 patients in our sample received LAIs. Before initiating LAIs, patients cycled through multiple OAPs (45% tried 1 or 2; 27% tried 3 or more OAP agents); PP1M LAI initiators had tried several different oral agents whereas most other LAI initiators had largely tried the same oral molecule (e.g., aripiprazole oral to aripiprazole LAI). The number of per-patient-per-year schizophrenia-related hospitalizations (1.9 vs. 1.1, pShort Description: This real-world study used 2006-2021 national fee-for-service Medicare and Medicaid claims data to examine long-acting injectable antipsychotic (LAI) treatment, clinical outcomes, and health resource utilization patterns over time among dually eligible Medicare & Medicaid beneficiaries. The analysis showed that only about one-third of patients received an LAI over nearly 6 years of follow-up. Before initiating LAIs, patients cycled through multiple OAPs. Initiating LAI was associated with statistically significant reduction in relapses, hospitalizations and ER visits.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC, a Johnson & Johnson company