Poster
105
(#105) Real-World Evidence of the Burden of Non-Adherence to Oral Olanzapine on Relapse and Healthcare Resource Utilization Among Adults With Schizophrenia
Psych Congress 2025
Abstract: In schizophrenia treatment, adherence to oral antipsychotics is challenging and can lead to poor outcomes.
This retrospective US MarketScan Medicaid Claims database analysis evaluated outcomes associated with non-adherence in adults with schizophrenia initiating oral olanzapine (2019-2021). Relapse (defined as having a claim for any of: hospitalization with schizophrenia, suicidal behavior, suicide attempt, injury with undetermined intent, suicidal ideation, homicidal ideation, exacerbation of schizophrenia, clozapine use, violent behavior, hostility, aggressive behavior) rates, time to relapse, and healthcare resource utilization (HCRU) were assessed for adherent (proportion of days covered [PDC]≥0.8) and non-adherent (PDC 0.8) propensity score-matched cohorts over 1 year. Incidence rate ratios (IRRs; adherent vs. non-adherent) for HCRU, hazard ratios (HRs), and time to relapse (Kaplan-Meier survival curves) were calculated.
Overall, 1468 participants were included (non-adherent/adherent cohorts: n=734 each). Mean(SD) PDC was 0.36(0.21) and 0.91(0.06) for non-adherent and adherent cohorts, respectively. The proportion of participants with ≥1 relapse (43.5% vs. 26.3%), number of relapses per participant (pp) overall (mean[SD]: 5.91[15.1] vs. 2.07[6.5]), and among those who had relapsed (13.59[20.5] vs. 7.89[10.6]) were significantly higher (p 0.0001) for non-adherent versus adherent cohorts. Time to relapse (Kaplan-Meier) was shorter for the non-adherent versus adherent cohort (HR[95%CI]: 1.85[1.55-2.22]; p 0.0001). The non-adherent cohort had, pp, significantly (p 0.0001) increased incidence of schizophrenia-related hospitalization (IRR[95%CI]: 0.39[0.3-0.5]), length of stay (0.32[0.22-0.47]), rehospitalization (0.30[0.19-0.46]), and emergency room visits (0.50[0.38-0.65]) than the adherent cohort.
Findings demonstrate the increased burden on relapse and HCRU associated with non-adherence to oral olanzapine treatment among adults with schizophrenia.
Short Description: Retrospective analysis of non-adherence (n=734) versus adherence (n=734) to oral olanzapine in adults with schizophrenia. Relapse rates were higher and time to relapse shorter for the non-adherent than the adherent cohort. Generally, the incidence of schizophrenia-related healthcare resource utilization was significantly increased among the non-adherent cohort (p 0.0001). Non-adherence to oral olanzapine demonstrated a higher risk of relapse and larger HCRU burden, suggesting the need for a viable olanzapine long-acting injectable to improve adherence and outcomes.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
This retrospective US MarketScan Medicaid Claims database analysis evaluated outcomes associated with non-adherence in adults with schizophrenia initiating oral olanzapine (2019-2021). Relapse (defined as having a claim for any of: hospitalization with schizophrenia, suicidal behavior, suicide attempt, injury with undetermined intent, suicidal ideation, homicidal ideation, exacerbation of schizophrenia, clozapine use, violent behavior, hostility, aggressive behavior) rates, time to relapse, and healthcare resource utilization (HCRU) were assessed for adherent (proportion of days covered [PDC]≥0.8) and non-adherent (PDC 0.8) propensity score-matched cohorts over 1 year. Incidence rate ratios (IRRs; adherent vs. non-adherent) for HCRU, hazard ratios (HRs), and time to relapse (Kaplan-Meier survival curves) were calculated.
Overall, 1468 participants were included (non-adherent/adherent cohorts: n=734 each). Mean(SD) PDC was 0.36(0.21) and 0.91(0.06) for non-adherent and adherent cohorts, respectively. The proportion of participants with ≥1 relapse (43.5% vs. 26.3%), number of relapses per participant (pp) overall (mean[SD]: 5.91[15.1] vs. 2.07[6.5]), and among those who had relapsed (13.59[20.5] vs. 7.89[10.6]) were significantly higher (p 0.0001) for non-adherent versus adherent cohorts. Time to relapse (Kaplan-Meier) was shorter for the non-adherent versus adherent cohort (HR[95%CI]: 1.85[1.55-2.22]; p 0.0001). The non-adherent cohort had, pp, significantly (p 0.0001) increased incidence of schizophrenia-related hospitalization (IRR[95%CI]: 0.39[0.3-0.5]), length of stay (0.32[0.22-0.47]), rehospitalization (0.30[0.19-0.46]), and emergency room visits (0.50[0.38-0.65]) than the adherent cohort.
Findings demonstrate the increased burden on relapse and HCRU associated with non-adherence to oral olanzapine treatment among adults with schizophrenia.
Short Description: Retrospective analysis of non-adherence (n=734) versus adherence (n=734) to oral olanzapine in adults with schizophrenia. Relapse rates were higher and time to relapse shorter for the non-adherent than the adherent cohort. Generally, the incidence of schizophrenia-related healthcare resource utilization was significantly increased among the non-adherent cohort (p 0.0001). Non-adherence to oral olanzapine demonstrated a higher risk of relapse and larger HCRU burden, suggesting the need for a viable olanzapine long-acting injectable to improve adherence and outcomes.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
