Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an eleven-year cohort in Brazil

Wallace Breno Barbosa, Juliana de Oliveira Costa, Livia Lovato Pires de Lemos, Rosângela Maria Gomes, Helian Nunes de Oliveira, Cristina Mariano Ruas, Francisco de Assis Acurcio, Corrado Barbui, Marion Bennie, Brian Godman, Augusto Afonso Guerra Júnior

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible.
LanguageEnglish
Pages697-709
Number of pages13
JournalApplied Health Economics and Health Policy
Volume16
Issue number5
Early online date27 Jul 2018
DOIs
Publication statusPublished - 31 Oct 2018

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Health Care Costs
Antipsychotic Agents
Brazil
Schizophrenia
Costs and Cost Analysis
Psychiatry
Ambulatory Care
Hospitalization
olanzapine
Cohort
Costs
Linear Models
Clozapine
Economics
Demography
Databases
Delivery of Health Care
Outpatient

Keywords

  • schizophrenia
  • antipsychotics drugs
  • atypical antipsychotics
  • pharmacoeconomics

Cite this

Barbosa, W. B., de Oliveira Costa, J., Lovato Pires de Lemos, L., Gomes, R. M., de Oliveira, H. N., Ruas, C. M., ... Guerra Júnior, A. A. (2018). Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an eleven-year cohort in Brazil. Applied Health Economics and Health Policy, 16(5), 697-709. https://doi.org/10.1007/s40258-018-0408-4
Barbosa, Wallace Breno ; de Oliveira Costa, Juliana ; Lovato Pires de Lemos, Livia ; Gomes, Rosângela Maria ; de Oliveira, Helian Nunes ; Ruas, Cristina Mariano ; de Assis Acurcio, Francisco ; Barbui, Corrado ; Bennie, Marion ; Godman, Brian ; Guerra Júnior, Augusto Afonso. / Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics : an eleven-year cohort in Brazil. In: Applied Health Economics and Health Policy. 2018 ; Vol. 16, No. 5. pp. 697-709.
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abstract = "Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7{\%} of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7{\%} of patients and represented 62.8{\%} of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible.",
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Barbosa, WB, de Oliveira Costa, J, Lovato Pires de Lemos, L, Gomes, RM, de Oliveira, HN, Ruas, CM, de Assis Acurcio, F, Barbui, C, Bennie, M, Godman, B & Guerra Júnior, AA 2018, 'Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics: an eleven-year cohort in Brazil' Applied Health Economics and Health Policy, vol. 16, no. 5, pp. 697-709. https://doi.org/10.1007/s40258-018-0408-4

Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics : an eleven-year cohort in Brazil. / Barbosa, Wallace Breno; de Oliveira Costa, Juliana; Lovato Pires de Lemos, Livia; Gomes, Rosângela Maria; de Oliveira, Helian Nunes; Ruas, Cristina Mariano; de Assis Acurcio, Francisco; Barbui, Corrado; Bennie, Marion; Godman, Brian; Guerra Júnior, Augusto Afonso.

In: Applied Health Economics and Health Policy, Vol. 16, No. 5, 31.10.2018, p. 697-709.

Research output: Contribution to journalArticle

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T1 - Costs in the treatment of schizophrenia in adults receiving atypical antipsychotics

T2 - Applied Health Economics and Health Policy

AU - Barbosa, Wallace Breno

AU - de Oliveira Costa, Juliana

AU - Lovato Pires de Lemos, Livia

AU - Gomes, Rosângela Maria

AU - de Oliveira, Helian Nunes

AU - Ruas, Cristina Mariano

AU - de Assis Acurcio, Francisco

AU - Barbui, Corrado

AU - Bennie, Marion

AU - Godman, Brian

AU - Guerra Júnior, Augusto Afonso

PY - 2018/10/31

Y1 - 2018/10/31

N2 - Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible.

AB - Background: Schizophrenia is associated with significant economic burden. In Brazil, antipsychotics drugs, outpatient and hospital services are provided by the Brazilian National Health System for patients with schizophrenia. However, there are few studies that capture the cost of managing these patients within the Brazilian NHS. This is important to appraise different management approaches within universal healthcare systems. Objective: Describe the costs associated with the treatment of schizophrenia in adults receiving atypical antipsychotics in Brazil from 2000 to 2010 through real world data. Methods: We integrated three national databases for adult patients with schizophrenia receiving one or more atypical antipsychotics. Only direct medical costs were assessed as the perspective is a public payer. A multivariate log-linear regression model was performed to evaluate associations between costs and clinical and demographic variables. Results: 174,310 patients with schizophrenia were identified with mean (± SD) annual costs of USD 1,811.92 ± 284.39 per patient. Atypical antipsychotics accounted for 79.7% of the total cost, with a mean (± SD) annual cost per patient of USD 1,578.74 ± 240.40. Mean (± SD) annual costs per patient of psychiatric hospitalization were USD 2,482.90 ± 302.92 and outpatient psychiatric care was USD 862.96 ± 160.18. Olanzapine was used by 47.7% of patients and represented 62.8% of the total cost of atypical antipsychotics. Patients who used clozapine had the highest mean annual cost per patient regarding outpatient psychiatric care and psychiatric hospitalization. Conclusions: Atypical antipsychotics were responsible for the majority of the schizophrenia treatment cost, and psychiatric hospitalization costs were the highest mean annual cost per patient. As a result, authorities should ensure good quality of use of atypical antipsychotic and encourage outpatient psychiatric care over psychiatric hospitalization where possible.

KW - schizophrenia

KW - antipsychotics drugs

KW - atypical antipsychotics

KW - pharmacoeconomics

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JF - Applied Health Economics and Health Policy

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