Characteristics and Utilization Patterns of Medicare Beneficiaries Initiating Long-Acting Injectable Antipsychotic...

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Psychiatry

Background:

• US Medicare beneficiaries in fee-for-service (FFS) and Medicare Advantage (MA) plans may exhibit differences in sociodemographics, treatment, and costs.
• Real-world evidence comparing these cohorts, particularly for long-acting injectable antipsychotic medications (LAI-AM), is limited.

Purpose of the Study:

• To provide a holistic understanding of Medicare beneficiaries using LAI-AM.
• To compare sociodemographic characteristics, treatment patterns, medication adherence, and healthcare costs between FFS and MA plan beneficiaries initiating LAI-AM.

Main Methods:

• Observational study of new LAI-AM users in FFS and MA plans (July 2017-December 2020).
• Data extracted from Medicare's Chronic Conditions Data Warehouse (FFS) and Carelon Research database (MA).
• Analysis included sociodemographic and clinical characteristics, proportion of days covered (PDC) for adherence, and healthcare costs pre- and post-index LAI-AM claim.

Main Results:

• 3180 FFS and 525 MA LAI-AM initiators identified.
• FFS cohort was younger, had more males, and resided more in the South and West compared to MA.
• Mean PDC was 0.52 (FFS) and 0.46 (MA), with only 33% (FFS) and 27% (MA) achieving adherence (PDC≥0.8). Total medical costs decreased, while pharmacy costs increased from baseline to follow-up in both cohorts.

Conclusions:

• Despite sociodemographic variations between FFS and MA plan beneficiaries initiating LAI-AM, treatment patterns and healthcare costs did not significantly differ.
• Findings suggest that plan type may not be a primary driver of treatment outcomes or costs for LAI-AM users in Medicare.