Effects of paliperidone palmitate on healthcare utilization and costs for patients with schizophrenia: A claim-based mirror-image study in South Korea
Dasom Lee 1, Boung Chul Lee 2, 3, Soo-Hee Choi 4, Do-Hyung Kang 1, Duk-In Jon 5, Myung Hun Jung 5*
1Emotional Information and Communication Technology Association, Seoul, Republic of Korea., 2Health Insurance Review and Assessment Service, Republic of Korea., 3Department of Psychiatry, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea., 4Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea., 5Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea
Received: October 1, 2019; Revised: December 5, 2019; Accepted: December 18, 2019; Published online: December 18, 2019.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations.
Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment.
Results: The results showed that patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p < .0001) and the associated costs increasing by USD 1,497.15 (p < .0001). In contrast, the number of admission days was reduced by 11.33 after starting PP treatment (p < .0001) and the associated costs were reduced by USD 1,220.75 (p < .0001).
Conclusions: Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.
Keywords: Schizophrenia, Paliperidone palmitate, Mirror-image study, prescription days, prescription costs, admission days, admission costs


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