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Does Non-Adherence Increase Treatment Costs in Schizophrenia?
Mark Pennington1, Paul McCrone2
1King's Health Economics, PO24 David Goldberg Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK. mark.w.pennington@kcl.ac.uk.
Pharmacoeconomics
|April 28, 2018
Summary
Medication non-adherence in schizophrenia treatment has mixed cost impacts. Lower drug expenses for non-adherent patients may offset higher hospitalization costs, suggesting adherence doesn't always reduce overall spending.
Area of Science:
- Psychiatry and Mental Health
- Health Economics
- Pharmacoeconomics
Background:
- Medication non-adherence is a significant challenge in schizophrenia treatment.
- Understanding the economic implications of non-adherence is crucial for evaluating cost-effectiveness of interventions.
Purpose of the Study:
- To conduct a comprehensive literature review on the cost impact of non-adherence to antipsychotic medications in schizophrenia patients.
- To synthesize findings regarding healthcare costs associated with adherence versus non-adherence.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, Embase, PsycINFO, HMIC) up to February 2018.
- Inclusion of studies reporting costs in schizophrenia patients, focusing on adherence to antipsychotics.
- Exclusion of studies comparing different pharmacological therapies, inclusion of behavioral intervention trials.
Main Results:
- Analysis of 28 studies revealed mixed findings on healthcare costs.
- Administrative data suggested lower pharmacy costs for non-adherent patients might offset increased hospitalization costs, particularly with high drug prices.
- Prospective data and behavioral intervention trials indicated that increasing adherence does not consistently reduce overall costs.
Conclusions:
- Inferences from administrative data are limited by potential selection bias.
- Trial data is constrained by small sample sizes.
- The current literature does not consistently support the assumption that non-adherence to antipsychotics increases healthcare costs in schizophrenia.
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