1 / 11

Douglas L. Leslie, PhD Robert Rosenheck, MD

Changes in Antipsychotic Pharmacotherapy and Healthcare Costs Following a New Diagnosis of Diabetes among Patients with Schizophrenia. Douglas L. Leslie, PhD Robert Rosenheck, MD

moana
Télécharger la présentation

Douglas L. Leslie, PhD Robert Rosenheck, MD

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Changes in Antipsychotic Pharmacotherapy and Healthcare Costs Following a New Diagnosis of Diabetes among Patients with Schizophrenia Douglas L. Leslie, PhD Robert Rosenheck, MD New England Mental Illness Research, Education and Clinical Center (MIRECC);VA Northeast Program Evaluation Center (NEPEC); Yale Medical School

  2. Background • First-generation antipsychotics were introduced in the 1950’s • Second-generation antipsychotics • clozapine, olanzapine, risperidone, quetiapine • At least as effective as first-generation drugs • Have fewer side effects • Associated with weight gain and diabetes • FDA warning

  3. Objectives • To determine risk of new-onset diabetes associated with antipsychotic medications. • To identify the costs associated with treatment of new-onset diabetes. • To determine whether patients switch antipsychotic medications after diagnosis of diabetes.

  4. Sample • Patients with schizophrenia treated in the VA Healthcare System. • No pre-existing diabetes. • “Stable” on an antipsychotic medication. • Followed for up to 2 years between June 1999 and September 2001. • 56,849 patients included in the study.

  5. Methods • Patients with a new diagnosis of diabetes were identified. • Cox proportional hazards model. • A matched control group of patients who did not develop diabetes was identified. • Medication changes and costs were compared.

  6. Study timeline June 1999 September 2001 D Diabetes patient Diabetes onset date Stable period (3 months) D Matched non-diabetes patient Stable period (3 months) Pseudo diabetes onset date

  7. Results • Patients were followed for an average of 15.7 months • 4,132 patients had a new diagnosis of diabetes – annual incidence rate of 4.36% • Unadjusted diabetes risk was highest for clozapine and olanzapine • Total healthcare costs were $3,104 higher for patients with diabetes

  8. Month

  9. Percentage of patients who switch/discontinue antipsychotic medication after diabetes onset

  10. Diabetes risk and costs attributable to second-generation drugs * Based on average cost of $198/month per case of diabetes

  11. Conclusions • Very high rate of diabetes onset in this population (4-5% per year) • Results do not support a “class effect” • Onset of diabetes does not affect antipsychotic pharmacotherapy • Diabetes risk and treatment costs attributable to second-generation drugs are small

More Related